Project Information

Project ID: 215220 DEA: 07210624 EFIS: 0719000068 QA Service Level: 1

DIST-CO-RTE-PM: 07-LA,SBD-71-1.8/R4.7&R0.0/R0.2

Work Description: PLACE STRUCTURE CONCRETE RETAINING WALLS & BOX CULVERT AND PLACE JPCP.

Location Description: IN LOS ANGELES AND SAN BERNARDINO COUNTIES IN POMONA AND CHINO HILLS FROM 0.2 MILE SOUTH OF MISSION BOULEVARD OVERCROSSING TO 0.2 MILE OF SAN BERNARDINO COUNTY LINE.

Contractor Name: OHL USA

Contractor Address: 1920 Main Street, Suite 310, Irvine, California 92614

Resident Engineer: Michael Wang Structure Rep.: Ryan Valentine

Sample Information

DIME Sample ID: 2024-11-26-28

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: 11/26/2024

Date that the sample was received by the laboratory/organization performing the testing: 11/26/2024

The quantity of what the sample constitutes: 27 SY

A brief description of the sample: Structural Backfill

From where was the sample collected: Job Site

Laboratory sample identification: 24-3654

Structure unique identifier:

Structure name: RCB 14-4

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: Structural backfill

The fabricator/manufacturer designation for the sample: Compaction testing

The plant number:

A detailed description of where the material sample was collected: Jobsite

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

Primary Aggregate Nominal Size: 3/4 inch

The concrete mix design number:

Lot number:

Sublot number:

Aggregate Mix Number:

Test Results

Test 1 of 2

DIME Test ID: 2024-11-26-28-1

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

Verified Date: 12/06/2024

Date Tested: 11/26/2024

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: complies

Additional Comments When Verified:

Standard Count Density	2417 g/cc
Count or Density 1	425 g/cc
Count or Density 2	417 g/cc
Count or Density 3	471 g/cc
Standard Count Moisture	773 g/cc
Moisture Count 1	113 g/cc
Moisture Count 2	127 g/cc
Moisture Count 3	130 g/cc
Sum of Count or Density	1313 g/cc
Average of Count or Density	437.67 g/cc
Sum of Moisture Count	370 g/cc
Average of Moisture Count	123.33 g/cc
Calculated Percent Relative Compaction	96 %
Reported Percent Relative Compaction	96 %

Test 2 of 2

DIME Test ID: 2024-11-26-28-2

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