Sample Record for 2023-10-24-108
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 210687 DEA: 07316604
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-1-41.8/42.1, 41.8-42.1
Work Description: INSTALL RSP TO PREVENT HIGH SURF FROM DESTROYING ROADWAY SUPPORT SLOPE, TRAVEL WAY
Location Description: IN LA,IN MALIBU 1MILE N/O TOPANGE CNY RD
Contractor Name: NORDIC INDUSTRIES, INC.
Contractor Address: 1437 FURNEAUX ROAD , OLIVEHURST, CA 95961
Resident Engineer: Gilbert Trujillo Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2023-10-24-108
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: 10/24/2023
Date that the sample was received by the laboratory/organization performing the testing: 10/24/2023
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: Native Soil
From where was the sample collected: Source
Laboratory sample identification: 23-1753
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
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2023-10-24-108-1 | CTM 231-March 2013: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates Using Nuclear Gages | 02/01/2024 | 10/24/2023 | SoCal Reports | Alta Vista Solutions - Whittier | | SoCal Reports |
| 2023-10-24-108-2 | CTM 216-June 2011: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates | 02/01/2024 | 10/24/2023 | SoCal Reports | Alta Vista Solutions - Whittier | | SoCal Reports |
9622296223
