Project Information

Project ID: 994351 DEA: 07322004 EFIS: 0716000053 QA Service Level: 1

DIST-CO-RTE-PM: 07-LA-118-R11.0/R14.0

Work Description: CONSTRUCT STORMWATER TREATMENT DEVICES.

Location Description: THE CITY AND COUNTY OF LOS ANGELES FROM 0.1 MILE WEST OF ARLETA AVENUE UNDERCROSSING TO 0.1 MILE WEST OF ROUTE 118/210 SEPARATION

Contractor Name: G&G Electric Inc.

Contractor Address: 4229 Giles Ct., Riverside, CA 92503

Resident Engineer: Wassem Bakhet Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2023-09-27-112

TL Number from the TL Form:

Sample Submitted By Organization: Alta Vista Solutions - Whittier

Sample Organization Contact: (510) 542-9827

Type of Sample: Quality Assurance

Type of Material: Aggregate

Sample Taken Date: 09/27/2023

Date that the sample was received by the laboratory/organization performing the testing: 09/27/2023

The quantity of what the sample constitutes: 83.3 sqft

A brief description of the sample: Structural Backfill

From where was the sample collected: Source

Laboratory sample identification: 23-1504

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: n/a

Material Information

Source Identification (SMARA, name of Pit or Job Site): n/a

The fabricator's/manufacturer's product name for the sample:

The fabricator/manufacturer designation for the sample:

The plant number:

A detailed description of where the material sample was collected: CTM 231 Test Holes

Where the material sample would have been placed if not sampled:

Primary Aggregate Nominal Size: 3/8 inch

The concrete mix design number:

Lot number:

Sublot number:

Aggregate Mix Number:

Test Results

Test 1 of 2

DIME Test ID: 2023-09-27-112-1

Test Method: CTM 231-March 2013: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates Using Nuclear Gages

Verified Date: 01/03/2024

Date Tested: 09/27/2023

Submitted By Organization: Alta Vista Solutions - Whittier

Organization Address: 12409 Slauson Avenue, Suite I,

Organization City: Whittier

Organization State: CA

Organization Zipcode: 90606

Organization Email: nicholas.hoffmann@oneatlas.com

Organization Phone: (510) 542-9827

General Comments for this Test:

Test Result Compliance:

Additional Comments When Verified:

Standard Count Density	1513 g/cc
Count or Density 1	362 g/cc
Count or Density 2	506 g/cc
Count or Density 3	394 g/cc
Standard Count Moisture	641 g/cc
Moisture Count 1	145 g/cc
Moisture Count 2	138 g/cc
Moisture Count 3	147 g/cc
Sum of Count or Density	1262 g/cc
Average of Count or Density	421 g/cc
Sum of Moisture Count	430 g/cc
Average of Moisture Count	143 g/cc
Count Ratio Density	0.28
Count Ratio Moisture	0.22
Calculated Percent Relative Compaction	no data
Reported Percent Relative Compaction	no data

Test 2 of 2

DIME Test ID: 2023-09-27-112-2

Test Method: CTM 216-June 2011: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates