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Sample Record for 2021-11-01-4

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Project Information

Project ID: 215456 DEA: 07293604 EFIS: 0713000238 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-405-14.3/15.8
Work Description: CONSTRUCT AUXILIARY LANE AND WIDEN ON AND OFF RAMPS.
Location Description: LOS ANGELES COUNTY IN TORRANCE BETWEEN WESTERN AVENUE UNDERCROSSING AND WEST 182ND STREET
Contractor Name: ORTIZ ENTERPRISES, INC.
Contractor Address: 6 CUSHING SUITE 200, IRVINE CA 92618
Resident Engineer: Samuel Gallardo Structure Rep.: James Holloway

Sample Information

DIME Sample ID: 2021-11-01-4
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Acceptance
Type of Material: Soil
Sample Taken Date: 11/01/2021
Date that the sample was received by the laboratory/organization performing the testing: 11/01/2021
The quantity of what the sample constitutes: 16000 SF
A brief description of the sample: Soil for Embankment
From where was the sample collected: Job Site
Laboratory sample identification: 21-2683
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: NA

Material Information

The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Jobsite
Where the material sample would have been placed if not sampled:

Test Results

Test 1 of 2

DIME Test ID: 2021-11-01-4-1
Test Method: CTM 231-March 2013: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates Using Nuclear Gages
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 817-0387
Data has not been verified.

Test 2 of 2

DIME Test ID: 2021-11-01-4-2
Test Method: CTM 216-June 2011: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 817-0387
Data has not been verified.