Summary for Test 2023-12-13-21-3
Test performed: CTM 213-December 2012Project Information
| Project Identifiers | Project ID: 66666 DEA: APP EFIS: 0019000052 |
|---|---|
| DIST-CO-RTE-PM | 59--- |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | Special project for submitting Sample information for Aggregate Pre-approval Program (APP). Object Code: 1025. J2 DEA: 912680. |
| Location Description | Not set |
| QA Service Level | NOT VERIFIED |
Sample Information
| Sample Taken Date | 12/13/2023 | Sample Unique Key | 21 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | No | Date that the sample was received by the laboratory/organization performing the testing | 12/13/2023 |
| Sample type | Aggregate Prequalification Program | A brief description of the sample | WCS PCC Aggregate |
| The quantity of what the sample constitutes | 3 bags | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Kreetha | Last name of sampler or witnessed by | Mekchai |
| Title of sampler | Telephone number of sampler | 6267645399 | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Hi Grade Materials Lucerne Valley | Transportation Laboratory (TL) Number | |
| 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) | SMARA 91-36-0042 |
|---|---|---|---|
| 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 | Flat top under belt | |
| 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: 2023-12-13-21
DIME Test ID: 2023-12-13-21-3
Testing Lab: Hi Grade Materials
Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand
Test Release Date: 2024-01-03
Test Results
Input Type: Calculated
Tester's full name: Miguel Robles
Date of test: 12/13/2023
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 1000 characters):
Test was verified on 1/3/2024 ✔