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Sample Record for 2023-04-13-5

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

Project Information

Project ID: 215220 DEA: 07210624 EFIS: 0719000068 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,SBD-71-1.8/R4.7&R0.0/R0.2
Work Description: PLACE STRUCTURE CONCRETE RETAINING WALLS & BOX CULVERT AND PLACE JPCP.
Location Description: IN LOS ANGELES AND SAN BERNARDINO COUNTIES IN POMONA AND CHINO HILLS FROM 0.2 MILE SOUTH OF MISSION BOULEVARD OVERCROSSING TO 0.2 MILE OF SAN BERNARDINO COUNTY LINE.
Contractor Name: OHL USA
Contractor Address: 1920 Main Street, Suite 310, Irvine, California 92614
Resident Engineer: Michael Wang Structure Rep.: Ryan Valentine

Sample Information

DIME Sample ID: 2023-04-13-5
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: 04/13/2023
Date that the sample was received by the laboratory/organization performing the testing: 04/13/2023
The quantity of what the sample constitutes: 128 CY
A brief description of the sample: Structure Backfill
From where was the sample collected: Job Site
Laboratory sample identification: 23-0431
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: OHL

Material Information

The fabricator's/manufacturer's product name for the sample: Structural Backfill
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: from various location at structural backfill
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: 2023-04-13-5-1
Test Method: CTM 216-June 2011: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates
Verified Date: 04/13/2023
Date Tested: 04/13/2023
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Is oversize material No
In-place wet density 2.22
Highest adjust wet density 2.33
Relative compaction 95
% Moisture 8.5 %
Optimum Moisture 10.5 %

Test 2 of 2

DIME Test ID: 2023-04-13-5-2
Test Method: CTM 231-March 2013: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates Using Nuclear Gages
Verified Date: 04/13/2023
Date Tested: 04/13/2023
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Standard Count Density 2123 g/cc
Count or Density 1 2.23 g/cc
Count or Density 2 2.22 g/cc
Count or Density 3 2.2 g/cc
Standard Count Moisture 646 g/cc
Moisture Count 1 0.18 g/cc
Moisture Count 2 0.18 g/cc
Moisture Count 3 0.16 g/cc
Sum of Count or Density 6.65 g/cc
Average of Count or Density 2.22 g/cc
Sum of Moisture Count 0.52 g/cc
Average of Moisture Count 0.17 g/cc
Calculated Percent Relative Compaction 95.1 %
Reported Percent Relative Compaction 95 %