Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215299 DEA: 07260804 EFIS: 0712000104
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-10,405-16.6/30.1,4.8/8.7
Work Description: CONSTRUCT GROSS SOLIDS REMOVAL DEVICES, BIOSWALES AND MEDIA FILTERS.
Location Description: LOS ANGELES COUNTY AT VARIOUS LOCATIONS ON ROUTE 10 0.1 MILE WEST OF SANTA FE AVENUE TO 0.2 MILE WEST OF COGSWELL ROAD UNDERCROSSING AND ON ROUTE 405 0.1 MILE EAST OF CHEERY AVENUE OVERCROSSING TO 0.1 MILE WEST OF SOUTH ALAMEDA STREET UNDERCROSSING
Contractor Name: POWELL CONSTRUCTORS, INC.
Contractor Address: 1355 Brooks Street, Unit "F", Ontario, CA 91762
Resident Engineer: Mesfin Hailu Structure Rep.: Unknown
DIME Sample ID: 2022-04-18-52
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Department Acceptance
Type of Material: Soil
Sample Taken Date: 04/18/2022
Date that the sample was received by the laboratory/organization performing the testing: 04/18/2022
The quantity of what the sample constitutes: 133 cy
A brief description of the sample: Soil for Aggregate Base
From where was the sample collected: Job Site
Laboratory sample identification: 22-0837
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Peterson Chase
The fabricator's/manufacturer's product name for the sample: Subgrade
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: From various locations at subgrade
Where the material sample would have been placed if not sampled:
DIME Test ID: 2022-04-18-52-1
Test Method: CTM 231-March 2013: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates Using Nuclear Gages
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 817-0387
Data has not been verified.
DIME Test ID: 2022-04-18-52-2
Test Method: CTM 216-June 2011: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 817-0387
Data has not been verified.
