Summary for Test 2018-11-29-9-1
Test performed: CTM 213-December 2012Project Information
| Project Identifiers | Project ID: 211778 DEA: 04235654 EFIS: 0400000680 |
|---|---|
| DIST-CO-RTE-PM | 04-SM-101,114-1.3/2.5,5.0/5.3 |
| Award Date | 02/10/2017 |
| Closeout Date | 01/08/2020 |
| Work Description | RECONSTRUCT INTERCHANGE |
| Location Description | SAN MATEO COUNTY AT VARIOUS LOCATIONS ON ROUTE 101 FROM 0.4 MILE NORTH OF UNIVERSITY AVENUE OVERCROSSING TO 0.6 MILE SOUTH OF HENDERSON UNDERPASS AND ON ROUTE 114 FROM WILLOW ROAD SEPARATION TO NEWBRIDGE STREET |
| QA Service Level | 1 (Verified on 10/24/2016) |
Sample Information
| Sample Taken Date | 11/29/2018 | Sample Unique Key | 9 |
|---|---|---|---|
| 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 | 02/19/2019 |
| Sample type | Annual Source Testing | A brief description of the sample | Fine |
| The quantity of what the sample constitutes | 1 bags | 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 | Consultant | Telephone number of sampler | |
| Laboratory sample identification | 19-FPCC-0034 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | AR Wilson Aromas | Transportation Laboratory (TL) Number | C811344 |
| 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) | 91-35-0012::A.R. WILSON QUARRY |
|---|---|---|---|
| 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 | stock pile |
| 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 | Unknown |
| Sublot number | Unknown | Aggregate Mix Number | Not set |
Test Details
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DIME Sample ID: 2018-11-29-9
DIME Test ID: 2018-11-29-9-1
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: 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 ✔