Summary for Test 2022-12-22-65-1
Test performed: CTM 213-December 2012Project Information
| Project Identifiers | Project ID: 993333 DEA: 04264724 EFIS: 0419000068 |
|---|---|
| DIST-CO-RTE-PM | 04-MRN-101-R20.8/27.1 |
| Award Date | 04/26/2022 |
| Closeout Date | Not set |
| Work Description | CIP BRIDGES, CONSTRUCT ROADWAY, RETAINING WALLS AND MODIFY ELECTRICAL. |
| Location Description | MARIN COUNTY IN AND NEAR NOVATO FROM 0.1 MILE SOUTH OF FRANKLIN AVENUE OVERHEAD TO 0.5 MILE SOUTH OF SAN ANTONIO CREEK BRIDGE |
| QA Service Level | 1 (Verified on 11/01/2021) |
Sample Information
| Sample Taken Date | 12/22/2022 | Sample Unique Key | 65 |
|---|---|---|---|
| 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 | 03/16/2023 |
| Sample type | Annual Source Testing | A brief description of the sample | Fine aggregate |
| The quantity of what the sample constitutes | 1 bag | From where was the sample collected | Source |
| First name of sampler or witnessed by | Casey | Last name of sampler or witnessed by | F |
| Title of sampler | Plant QC | Telephone number of sampler | |
| Laboratory sample identification | 23-ASF-0038 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Mark West Quarry | Transportation Laboratory (TL) Number | C101306 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-49-0032 |
|---|---|---|---|
| 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 | Santa Rosa CA | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | fine | |
| The concrete mix design number | Lot number | ||
| Sublot number | Aggregate Mix Number |
Test Details
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DIME Sample ID: 2022-12-22-65
DIME Test ID: 2022-12-22-65-1
Testing Lab: CT HQ - Sacramento Aggregate Testing Laboratory
Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand
Test Release Date: 2023-05-02
Test Results
Input Type: Measured
Tester's full name: Bang Nguyen
Date of test: 04/20/2023
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 1000 characters):
Test was verified on 5/2/2023 ✔