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: Sam Toutounchian Structure Rep.: Darwin Vargas
DIME Sample ID: 2023-07-06-119
TL Number from the TL Form:
Sample Submitted By Organization: Coreslab
Sample Organization Contact: (909) 936-7741
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 07/06/2023
Date that the sample was received by the laboratory/organization performing the testing: 07/06/2023
The quantity of what the sample constitutes: 1 WEEK
A brief description of the sample: 3/8" GRAVEL
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier: 53-3104
Structure name: LIBERTY CANYON WILDLIFE CROSSING
The fabricator/manufacturer/facility name: Coreslab Structures L.A., Inc.
Source Identification (SMARA, name of Pit or Job Site): Vulcan Corona
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: BIN
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/8 inch
The concrete mix design number: 2251-1
Lot number:
Sublot number:
Aggregate Mix Number:
DIME Test ID: 2023-07-06-119-1
Test Method: ASTM C136-19: Standard Test Method for Sieve Analysis of Fine and Coarse Aggregates
Submitted By Organization: Coreslab
Organization Address: 150 West Placentia Avenue,
Organization City: Perris
Organization State: CA
Organization Zipcode: 92571
Organization Email: bmalott@coreslab.com
Organization Phone: (909) 936-7741
Data has not been verified.
