Project Information

Project ID: 1000103 DEA: 081J8604 EFIS: 0818000123 QA Service Level: 1

DIST-CO-RTE-PM: 08-SBD-10,15,40,58,60,etc.-Var

Work Description: MODIFYING CMS SYSTEMS AND FURNISH SIGN STRUCTURE (VERSATILE TRUSS).

Location Description: SAN BERNARDINO COUNTY AT VARIOUS LOCATIONS

Contractor Name: PETERSON-CHASE GENERAL ENGINEERING CONSTRUCTION, INC.

Contractor Address: 16351 Construction Circle West, Irvine, CA 92606

Resident Engineer: Lawrance Yaacoub Structure Rep.: Matt Bruce

Sample Information

DIME Sample ID: 2025-12-05-9

TL Number from the TL Form:

Sample Submitted By Organization: CT D08 - Barstow Field Laboratory 1

Sample Organization Contact: (760) 252-9216

Type of Sample: Acceptance

Type of Material: Soil

Sample Taken Date: 12/05/2025

Date that the sample was received by the laboratory/organization performing the testing: 12/05/2025

The quantity of what the sample constitutes: 20,367g

A brief description of the sample: Class II Base

From where was the sample collected: Job Site

Laboratory sample identification:

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: MVP Location 14

Material Information

The fabricator's/manufacturer's product name for the sample:

The fabricator/manufacturer designation for the sample:

A detailed description of where the material sample was collected: Job site, NB I-15 PM 29.56, MVP L-14

Where the material sample would have been placed if not sampled:

Test Results

Test 1 of 2

DIME Test ID: 2025-12-05-9-1

Test Method: CTM 231-March 2013: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates Using Nuclear Gages

Verified Date: 12/05/2025

Date Tested: 12/05/2025

Submitted By Organization: CT D08 - Barstow Field Laboratory 1

Organization Address: 13970 Victoria Street,

Organization City: Fontana

Organization State: CA

Organization Zipcode: 92336

Organization Email: kaushalkumar.talati@dot.ca.gov

Organization Phone: (951) 840-8328

General Comments for this Test: Density Spec 95%

Test Result Compliance:

Additional Comments When Verified:

Sum of Count or Density	4710 g/cc
Average of Count or Density	1570 g/cc
Sum of Moisture Count	176 g/cc
Average of Moisture Count	59 g/cc
Count Ratio Density	2.23
Count Ratio Moisture	0.06
Calculated Percent Relative Compaction	98.7 %
Reported Percent Relative Compaction	99 %

Test 2 of 2

DIME Test ID: 2025-12-05-9-2

Test Method: CTM 216-June 2011: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates