DIME - Test Summary

Summary for Test 2021-12-06-55-4

Test performed: CTM 205-December 2010

Project Identifiers	Project ID: 215501 DEA: 112N0744 EFIS: 1119000166
DIST-CO-RTE-PM	11-SD-163-5.6/R11.2
Award Date	03/30/2021
Closeout Date	09/14/2023
Work Description	APPLY MICRO-SURFACING AND PLACE PAVEMENT DELINEATION AT RAMPS.
Location Description	SAN DIEGO COUNTY IN SAN DIEGO FROM 1.3 MILES NORTH OF FRIARS ROAD OVERCROSSING TO 0.3 MILE NORTH OF KEARNY VILLA ROAD OVERCROSSING
QA Service Level	1 (Verified on 07/19/2021)

Sample Taken Date	12/06/2021	Sample Unique Key	55
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 testing	12/07/2021
Sample type	Quality Assurance	A brief description of the sample	3/8" Type III Aggregate
The quantity of what the sample constitutes	2 bags	From where was the sample collected	Source
First name of sampler or witnessed by	Farsheed	Last name of sampler or witnessed by	Fani
Title of sampler	Assistant RE	Telephone number of sampler
Laboratory sample identification		Linked DIME Sample ID
The fabricator/manufacturer/facility name	Coachella Valley	Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name

Material Type	Aggregate	Source Identification (SMARA, name of Pit or Job Site)	not provided
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 collected	Plant
Where the material sample would have been placed if not sampled		Primary Aggregate Nominal Size	3/8 inch
The concrete mix design number		Lot number
Sublot number		Aggregate Mix Number	Not set

DIME Sample ID: 2021-12-06-55

DIME Test ID: 2021-12-06-55-4

Testing Lab: CT D11 - District 11 Materials Laboratory

Test Method: CTM 205-December 2010: Method of Test for Determining Percentage of Crushed Particles

Test Release Date: 2022-01-13

Will you be using 1/4 in. x No. 4 sieve?: No

Input Type: Calculated

Tester's full name: Daniel Smith

Date of test: 01/07/2022

Percent Coarse Crushed: 97.5 %

Percent Fine Crushed: 100 %

General comments (publicly viewable) (Max 1000 characters): Pass

Test was verified on 1/13/2022 ✔