DIME - Test Summary

Summary for Test 2019-08-08-37-8

Test performed: CTM 213-December 2012

Project Identifiers	Project ID: 212888 DEA: 07202124 EFIS: 0700020870
DIST-CO-RTE-PM	07-LA-710-20.9/24.6
Award Date	02/16/2018
Closeout Date	05/04/2022
Work Description	PAVEMENT REHABILITATION AND BRIDGE WIDENING
Location Description	LOS ANGELES COUNTY IN AND NEAR BELL, VERNON, AND CITY OF COMMERCE, FROM 0.2 MILE SOUTH OF SLAUSON AVENUE OVERCROSSING TO 0.1 MILE NORTH OF THIRD STREET OVERCROSSING
QA Service Level	1 (Verified on 03/29/2018)

Sample Taken Date	08/08/2019	Sample Unique Key	37
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	08/08/2019
Sample type	Annual Source Testing	A brief description of the sample	Washed Concrete Sand
The quantity of what the sample constitutes	4 Bags	From where was the sample collected	Source
First name of sampler or witnessed by	Robert	Last name of sampler or witnessed by	Cortenas
Title of sampler		Telephone number of sampler
Laboratory sample identification	8677	Linked DIME Sample ID
The fabricator/manufacturer/facility name	United Rock Products Irwindale	Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name

Material Type	Aggregate	Source Identification (SMARA, name of Pit or Job Site)	91-19-0052
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	At the plant
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

DIME Sample ID: 2019-08-08-37

DIME Test ID: 2019-08-08-37-8

Testing Lab: CT D08 - Fontana Southern Regional Laboratory

Test Method: CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand

Test Release Date: 2019-09-04

Input Type: Calculated

Tester's full name: Satish Jain

Date of test: 08/21/2019

Is the sample satisfactory or not?: Yes

Does debris exist: No

General comments (publicly viewable) (Max 1000 characters):

Test was verified on 9/4/2019 ✔