Summary for Test 2018-01-08-7-1
Test performed: CTM 213-December 2012Project Information
| Project Identifiers | Project ID: 212062 DEA: 040K9504 EFIS: 0416000173 |
|---|---|
| DIST-CO-RTE-PM | 04-SCL-17-2.8/7.5 |
| Award Date | 04/04/2017 |
| Closeout Date | 08/22/2018 |
| Work Description | HM1 - REPLACE ASPHALT CONCRETE SURFACING. |
| Location Description | SANTA CLARA COUNTY IN SANTA CLARA AND LOS GATOS FROM 0.1 MILE NORTH OF HEBARD WAY TO 0.16 MILE SOUTH OF BLOSSOM HILL ROAD |
| QA Service Level | 1 (Verified on 04/20/2017) |
Sample Information
| Sample Taken Date | 01/08/2018 | Sample Unique Key | 7 |
|---|---|---|---|
| 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 | 03/29/2018 |
| Sample type | Annual Source Testing | A brief description of the sample | Fine PCC Aggregate |
| The quantity of what the sample constitutes | 1 bag | From where was the sample collected | Source |
| First name of sampler or witnessed by | Fernando | Last name of sampler or witnessed by | Vega |
| Title of sampler | Unknown | Telephone number of sampler | Unknown |
| Laboratory sample identification | 18-0044 | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | Triangle Rock Los Banos | Transportation Laboratory (TL) Number | C811334 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | Not set |
| Structure name | Not set |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-24-0009::LOS BANOS |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| The plant number | Unknown | A detailed description of where the material sample was collected | Stockpile |
| Where the material sample would have been placed if not sampled | Unknown | Primary Aggregate Nominal Size | fine |
| The concrete mix design number | Unknown | Lot number | Not set |
| Sublot number | Not set | Aggregate Mix Number | Not set |
| HMA Pay | No |
Test Details
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DIME Sample ID: 2018-01-08-7
DIME Test ID: 2018-01-08-7-1
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: 2018-04-12
Test Results
Input Type: Measured
Tester's full name: Phillip Montes
Date of test: 04/05/2018
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 1000 characters):
Test was verified on 4/5/2018 ✔