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Sample Record for 2025-11-26-31

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 1000081 DEA: 081J5404 EFIS: 0818000069 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-2.4
Work Description: CB, JPCP (RSC), STRUCTURAL CONCRETE AND MODIFYING LIGHTING SYSTEMS.
Location Description: SAN BERNARDINO COUNTY IN ONTARIO AT ROUTE 10/15 SEPARATION
Contractor Name: FLATIRON WEST, INC.
Contractor Address: 12121 Scripps Summit Drive, Suite 400, San Diego, CA 92131
Resident Engineer: Giang-Sinh Tran Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2025-11-26-31
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: 9512323690
Type of Sample: Acceptance
Type of Material: Soil
Sample Taken Date: 11/26/2025
Date that the sample was received by the laboratory/organization performing the testing: 11/26/2025
The quantity of what the sample constitutes: 23.7 kg
A brief description of the sample: Structural Backfill
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CTM 231 TEST LOCATION

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: I-15 SB to I-10 EB Connector, Retaining Wall Footing 302, Sta 134+05 - 135+01
Where the material sample would have been placed if not sampled:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2025-11-26-31-1
Test Method: CTM 231-March 2013: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates Using Nuclear Gages
Verified Date: 03/02/2026
Date Tested: 11/26/2025
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Due to test owner's privacy settings, you do not have permission to view this test data.

Test 2 of 2

DIME Test ID: 2025-11-26-31-2
Test Method: CTM 216-June 2011: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates
Verified Date: 03/02/2026
Date Tested: 11/26/2025
Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: prakash.gowda@dot.ca.gov
Organization Phone: (951) 232-3690
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Due to test owner's privacy settings, you do not have permission to view this test data.