Sample Record for 2017-02-01-7
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 209141 DEA: 07215954 EFIS: 0700001835
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-0.0/7.6
Work Description: WIDENING FREEWAY AND RECONSTRUCT OVERHEAD AND OVERCROSSING STRUCTURES
Location Description: LOS ANGELES COUNTY IN LA MIRADA, SANTA FE SPRINGS, NORWALK AND DOWNEY FROM ORANGE COUNTY/LOS ANGELES COUNTY LIMIT LINES TO 0.7 MILE NORTH OF ROUTE 605
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 13170 TELFAIR AVENUE, SYLMAR, CA 91342
Resident Engineer: Thang Ton Structure Rep.: Amare Tsagie
Sample Information
DIME Sample ID: 2017-02-01-7
TL Number from the TL Form: Unknown
Sample Submitted By Organization: G3 Quality, Incorporated - Cerritos
Sample Organization Contact: (562) 321-9840
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 02/01/2017
Date that the sample was received by the laboratory/organization performing the testing: 11/01/2016
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: rock and sand
From where was the sample collected: Source
Laboratory sample identification: Mix G3-15-3600
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Security Paving - Florance
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-19-0025::IRWINDALE
The fabricator's/manufacturer's product name for the sample: set 1
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Batch Plant
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number: G3-15-3600
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
Test 1 of 5
DIME Test ID: 2017-02-01-7-1
Test Method: CTM 202-Oct 2014: Method of Test for Determining Sieve Analysis of Fine and Coarse Aggregates
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: (562) 321-9840
This test has been superseded on 03/01/2017.
Reason: corrected
Test 2 of 5
DIME Test ID: 2017-02-01-7-2
Test Method: CTM 202-Oct 2014: Method of Test for Determining Sieve Analysis of Fine and Coarse Aggregates
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: (562) 321-9840
This test has been superseded on 03/01/2017.
Reason: corrected
Test 3 of 5
DIME Test ID: 2017-02-01-7-3
Test Method: CTM 217-November 2014: Method of Test for Sand Equivalent
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: (562) 321-9840
This test has been superseded on 03/01/2017.
Reason: corrected
Test 4 of 5
DIME Test ID: 2017-02-01-7-4
Test Method: CTM 226-July 2010: Method of Test for Determination of Moisture Content of Soils and Aggregates by Oven Drying
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: (562) 321-9840
This test has been superseded on 03/01/2017.
Reason: corrected
Test 5 of 5
DIME Test ID: 2017-02-01-7-5
Test Method: CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)
Submitted By Organization: G3 Quality, Incorporated - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: (562) 321-9840
This test has been superseded on 03/01/2017.
Reason: corrected
