Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001037 DEA: 043X0804 EFIS: 0425000188
QA Service Level: 1
DIST-CO-RTE-PM: 04-SON-1-7.21
Work Description:
Location Description:
Contractor Name: Ghilotti Construction Company Inc
Contractor Address: 246 Ghilotti Ave,, Santa rosa, CA 95407
Resident Engineer: Harley Paulo Structure Rep.: Nick Abuhamdieh
DIME Sample ID: 2025-04-29-56
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Petaluma Field Laboratory
Sample Organization Contact: 510-385-7413
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 04/29/2025
Date that the sample was received by the laboratory/organization performing the testing: 04/29/2025
The quantity of what the sample constitutes: 89 SQYD
A brief description of the sample: SBFL
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Stony point/ Roblar Quarry
Source Identification (SMARA, name of Pit or Job Site): 91-49-0066
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: STA 10+00-12+00
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
DIME Test ID: 2025-04-29-56-1
Test Method: CTM 216-June 2011: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates
Verified Date: 05/06/2025
Date Tested: 04/29/2025
Submitted By Organization: CT D04 - Petaluma Field Laboratory
Organization Address: 3401 Regatta Blvd.,
Organization City: Richmond
Organization State: CA
Organization Zipcode: 94804
Organization Email: ignacio.arechiga@dot.ca.gov
Organization Phone: (510) 385-7413
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
|
Is oversize material
|
No
|
|
In-place wet density
|
2.32
|
|
Highest adjust wet density
|
2.41
|
|
Relative compaction
|
96
|
|
% Moisture
|
no data
|
|
Optimum Moisture
|
no data
|
