Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994978 DEA: 09379504 EFIS: 0919000009
QA Service Level: 1
DIST-CO-RTE-PM: 09-INY-5709-
Work Description: CONSTRUCT BUILDING AND PLACE HMA.
Location Description: INYO COUNTY AT INDEPENDENCE AT THE INDEPENDENCE MAINTENANCE STATION AT 665 NORTH EDWARDS STREET
Contractor Name: FEC FUTURE CONTRACTORS AND ENGINEERS INC
Contractor Address: 184 Technology Drive, Irvine, CA 92618
Resident Engineer: George Elzawy Structure Rep.: Derek Armon
DIME Sample ID: 2024-12-17-13
TL Number from the TL Form: 4552
Sample Submitted By Organization: CT D09 - Bishop Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 12/17/2024
Date that the sample was received by the laboratory/organization performing the testing: 12/17/2024
The quantity of what the sample constitutes: 250 cy
A brief description of the sample: Con Sand
From where was the sample collected: Source
Laboratory sample identification: CS-02
Structure unique identifier:
Structure name: Water Tank Footings
The fabricator/manufacturer/facility name: 7-11 Bishop Plant
Source Identification (SMARA, name of Pit or Job Site): 00-00-0000
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Stockpile Back Drag
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: fine
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
DIME Test ID: 2024-12-17-13-1
Test Method: AASHTO T176-08: Standard Method of Test for Plastic Fines in Graded Aggregates and Soils by Use of the Sand Equivalent Test (Sand Equivalent)
Verified Date: 12/18/2024
Date Tested: 12/18/2024
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
General Comments for this Test: Con Sand 02 Failed Spec but within Contract Compliance Spec=75min Contract Compliance=71min
Test Result Compliance: does not comply
Additional Comments When Verified:
