Summary for Test 2021-09-24-14-3

Test performed: CTM 227-December 2014

Project Information

Project IdentifiersProject ID: 215753
DEA: 050N72U4
EFIS: 0520000169
DIST-CO-RTE-PM05-SB-101-4.4/R7.7
Award Date03/01/2021
Closeout DateNot set
Work DescriptionConstruct High Occupancy Vehicle (HOV) lanes on U.S. Route 101 and rehabilitation - Segment 4B.
Location Description101 freeway in Summerland, CA
QA Service Level1 (Verified on 05/06/2021)

Sample Information

Sample Taken Date09/24/2021 Sample Unique Key14
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing09/24/2021
Sample typeQuality Control A brief description of the sample1", 3/8", sand
The quantity of what the sample constitutes3 bags From where was the sample collectedSource
First name of sampler or witnessed byIsidro Last name of sampler or witnessed byBuenrostro
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHanson - Goleta Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-40-0003
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedConveyor Belt
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1 inch
The concrete mix design number75F1SWZ Lot number
Sublot number HMA Design ID

Test Details

DIME Sample ID: 2021-09-24-14
DIME Test ID: 2021-09-24-14-3
Testing Lab: Sequoia Consultants
Test Method: CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)
Test Release Date: 2021-09-29

Test Results


Describe the gradation of the aggregate or the test method:: All aggregate is the same size
Input Type: Calculated
Tester's full name: Jairo Zepeda
Date of test: 09/27/2021
Cleanness value (single primary size):89
General comments (publicly viewable) (Max 1000 characters):

Test was verified on 9/29/2021