Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215620 DEA: 01436404 EFIS: 0100000193
QA Service Level: 1
DIST-CO-RTE-PM: 01-DN-101-35.8/36.5
Work Description: Dr. Fine Bridge Replacement
Location Description: DR. FINE BRIDGE REPLACEMENT FROM LAKE EARL DR TO S FRED D. HAIGHT DR ON HWY 101 ACROSS SMITH RIVER.
Contractor Name: MCM Construction
Contractor Address: PO Box 620, North Highlands, Ca 95660
Resident Engineer: Clayton Malmberg Structure Rep.: Brian Cinkutis
DIME Sample ID: 2024-05-30-12
TL Number from the TL Form:
Sample Submitted By Organization: CT D01 - Crescent City Field Laboratory
Sample Organization Contact: (707) 496-5581
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 05/30/2024
Date that the sample was received by the laboratory/organization performing the testing: 05/30/2024
The quantity of what the sample constitutes: 2 buckets
A brief description of the sample: Structure Backfill(3/4"-)
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: Dr fine bridge
The fabricator/manufacturer/facility name: Tidewater/Hole Pit
Source Identification (SMARA, name of Pit or Job Site): Tidewater/Hole Pit
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: Abutment 1(East Embankment)
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
DIME Test ID: 2024-05-30-12-1
Test Method: CTM 216-June 2011: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates
Verified Date: 05/30/2024
Date Tested: 05/30/2024
Submitted By Organization: CT D01 - Crescent City Field Laboratory
Organization Address: 1444 Parkway Dr.,
Organization City: Crescent City
Organization State: CA
Organization Zipcode: 95531
Organization Email: clayton.malmberg@dot.ca.gov
Organization Phone: (707) 496-5581
General Comments for this Test: Sample tested was the east embankment at abutment 1.
Test Result Compliance: complies
Additional Comments When Verified:
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Is oversize material
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No
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In-place wet density
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2.37
|
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Highest adjust wet density
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2.44
|
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Relative compaction
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97
|
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% Moisture
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no data
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|
Optimum Moisture
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no data
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