Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214697 DEA: 07307104 EFIS: 0714000213
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-101-32.8
Work Description: CONSTRUCT BRIDGE.
Location Description: LOS ANGELES COUNTY IN AND NEAR AGOURA HILLS FROM 0.1 MILE WEST OF LIBERTY CANYON ROAD UNDERCROSSING TO 0.6 MILE EAST OF PALO COMADO OVERCROSSING
Contractor Name: CA Rasmussen
Contractor Address: 28548 LIVINGSTON AVENUE, VALENICA CA 91355
Resident Engineer: Vladimir Gurfinkel Structure Rep.: Darwin Vargas
DIME Sample ID: 2026-07-03-5
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: 07/03/2026
Date that the sample was received by the laboratory/organization performing the testing: 07/03/2026
The quantity of what the sample constitutes: 27 SY
A brief description of the sample: Existing Subgrade
From where was the sample collected: Job Site
Laboratory sample identification: 26-2253
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Structure Backfill 001
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: 2026-07-03-5-1
Test Method: CTM 231-March 2013: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates Using Nuclear Gages
Verified Date: 07/22/2026
Date Tested: 07/03/2026
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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8431 g/cc
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Average of Count or Density
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2810 g/cc
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Sum of Moisture Count
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12640 g/cc
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Average of Moisture Count
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4213 g/cc
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Count Ratio Density
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2
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Count Ratio Moisture
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0.21
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Calculated Percent Relative Compaction
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90.1 %
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Reported Percent Relative Compaction
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90 %
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