Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994966 DEA: 073255U4 EFIS: 0722000129
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-605-20.2/26
Work Description: INDIVIDUAL SLAB REPLACEMENT, COLD PLANE AC
Location Description: LOS ANGELES COUNTY IN BALDWIN PARK AND IRWINDALE FROM ROUTE 10/605 SEPARATION TO 0.2 MILE NORTH OF ROUTE 210/605 SEPARATION
Contractor Name: Peterson Chase General Engineering
Contractor Address: 16351 Construction Circle West, Irvine, CA 92606
Resident Engineer: Steven Taing Structure Rep.: Unknown
DIME Sample ID: 2025-12-04-26
TL Number from the TL Form:
Sample Submitted By Organization: Kleinfelder, Incorporated - Los Angeles
Sample Organization Contact: (909) 833-5780
Type of Sample: Quality Assurance
Type of Material: Soil
Sample Taken Date: 12/04/2025
Date that the sample was received by the laboratory/organization performing the testing: 12/04/2025
The quantity of what the sample constitutes: 147.3 CY
A brief description of the sample: Subgrade
From where was the sample collected: Job Site
Laboratory sample identification: 25-3820
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Existing Subgrade
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: CTM 231 test location
Where the material sample would have been placed if not sampled:
DIME Test ID: 2025-12-04-26-1
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: 12/04/2025
Submitted By Organization: Kleinfelder, Incorporated - Los Angeles
Organization Address: 620 South Magnolia Avenue, Building G,
Organization City: Ontario
Organization State: CA
Organization Zipcode: 91762
Organization Email: mdorsch@kleinfelder.com
Organization Phone: (909) 833-5780
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Sum of Count or Density
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7952 g/cc
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Average of Count or Density
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2651 g/cc
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Sum of Moisture Count
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304 g/cc
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Average of Moisture Count
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101 g/cc
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Count Ratio Density
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1.7
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Count Ratio Moisture
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0.11
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Calculated Percent Relative Compaction
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79.8 %
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Reported Percent Relative Compaction
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80 %
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