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Sieve Analysis Test Report: Testing Information

This 2-page sieve analysis test report summarizes the results of testing conducted on a sample from a school district construction project. The report provides information on the sample weight before and after washing, total weight loss from sieving, weights retained on each sieve size, cumulative weights retained, percentage retained on each sieve, and percentage passing. Test methods and specifications are listed. In remarks, it is noted whether the material sampled and tested met the requirements of the approved documents.

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Vishwath Ram
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345 views2 pages

Sieve Analysis Test Report: Testing Information

This 2-page sieve analysis test report summarizes the results of testing conducted on a sample from a school district construction project. The report provides information on the sample weight before and after washing, total weight loss from sieving, weights retained on each sieve size, cumulative weights retained, percentage retained on each sieve, and percentage passing. Test methods and specifications are listed. In remarks, it is noted whether the material sampled and tested met the requirements of the approved documents.

Uploaded by

Vishwath Ram
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 2

FORM

DSA-202
Rev. 02/11

SIEVE ANALYSIS TEST REPORT


School District: _________________________________________ LEA #: Attn: _________________________________________ Exp. Date: Address: CA
Project Name: ________________________________ Location in Structure:_________________________ Sampled Location: By:

DSA FILE #: DSA APPL #: -

Lab Facility: Lab Doc. #:


_____________ Structure:

Lab Job #:
Report Date: ____________________________ Sample Date:

TESTING INFORMATION
Weight Retained (grams)

Sample weight before wash (g): Sample weight after wash (g): Total loss after sieving, <0.3% (%):

Sieve size
2.5 (63.5 mm) 2 1.5 1 0.75 0.5 (50 mm) (37.5 mm) (25 mm) (19 mm) (12.5 mm)

Cumulative Weight Retained (g)

% Retained Each Sieve

% Passing

Specification

0.375 (9.5 mm) No.4 No.8 (4.75 mm) (2.36 mm)

No.16 (1.18 mm) No.30 No.50 (600 m) (300 m)

No.100 (150 m) No.200 (75 m)

Applicable ASTM Test Methods: __________

__________

The Material

SAMPLED AND TESTED IN ACCORDANCE WITH THE REQUIREMENTS OF THE DSA APPROVED DOCUMENTS.
cc: Project Architect Structural Engineer Project Inspector DSA Regional Office FORM DSA-202 (rev 02/16/11) Sieve Analysis Test Report

WAS

WAS NOT

ADDITIONAL COMMENTS (DSA-211) ATTACHED.

The Material Tested

THE REQUIREMENTS OF THE DSA APPROVED DOCUMENTS.

MET DID NOT MEET

Signature Print Name / Title

PAGE 1 OF 1
CALIFORNIA DEPARTMENT OF GENERAL SERVICES

FORM

DSA-202
Rev. 02/11

SIEVE ANALYSIS TEST REPORT


School District: _________________________________________ LEA #: Attn: _________________________________________ Exp. Date: Address: CA
Project Name: ________________________________ Location in Structure:_________________________ Sampled Location: By:

DSA FILE #: DSA APPL #: -

Lab Facility: Lab Doc. #:


_____________ Structure:

Lab Job #:
Report Date: ____________________________ Sample Date:

REMARKS:

The Material

SAMPLED AND TESTED IN ACCORDANCE WITH THE REQUIREMENTS OF THE DSA APPROVED DOCUMENTS.
cc: Project Architect Structural Engineer Project Inspector DSA Regional Office FORM DSA-202 (rev 02/16/11) Sieve Analysis Test Report

WAS

WAS NOT

ADDITIONAL COMMENTS (DSA-211) ATTACHED.

The Material Tested

THE REQUIREMENTS OF THE DSA APPROVED DOCUMENTS.

MET DID NOT MEET

Signature Print Name / Title

PAGE 2 OF 1
CALIFORNIA DEPARTMENT OF GENERAL SERVICES

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