Summary for Test 2018-11-28-17-3
Test performed: CTM 213-December 2012Project Information
| Project Identifiers | Project ID: 213002 DEA: 042640N4 EFIS: 0412000649 |
|---|---|
| DIST-CO-RTE-PM | 04-MRN,SON-101-MRN27.0/27.6SON0.0/4.5 |
| Award Date | 04/09/2018 |
| Closeout Date | 03/12/2021 |
| Work Description | CONSTRUCT HOV LANES |
| Location Description | MARIN AND SONOMA COUNTIES IN AND NEAR PETALUMA FROM 0.6 MILE SOUTH OF SAN ANTONIO CREEK BRIDGE TO 0.3 MILE SOUTH OF EAST WASHINGTON STREET OVER CROSSING |
| QA Service Level | 1 (Verified on 04/13/2018) |
Sample Information
| Sample Taken Date | 11/28/2018 | Sample Unique Key | 17 |
|---|---|---|---|
| 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 | 02/06/2019 |
| Sample type | Annual Source Testing | A brief description of the sample | Fine |
| The quantity of what the sample constitutes | 1 bag | From where was the sample collected | Source |
| First name of sampler or witnessed by | CJ | Last name of sampler or witnessed by | Sousa |
| Title of sampler | Plant QC | Telephone number of sampler | |
| Laboratory sample identification | 19-FPCC-0019 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Healdsburg Quarry | Transportation Laboratory (TL) Number | C805889 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | Not set | |
| Structure name | Not set |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-49-0062::HEALDSBURG TERRACE PHASE VI |
|---|---|---|---|
| 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 | 0 |
| Sublot number | 0 | Aggregate Mix Number | Not set |
Test Details
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DIME Sample ID: 2018-11-28-17
DIME Test ID: 2018-11-28-17-3
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: 2019-03-15
Test Results
Input Type: Calculated
Tester's full name: Bang Nguyen
Date of test: 03/15/2019
Is the sample satisfactory or not?: Yes
Does debris exist: No
General comments (publicly viewable) (Max 1000 characters):
Test was verified on 3/15/2019 ✔