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Sample Record for 2021-11-06-3

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Project Information

Project ID: 214573 DEA: 073096U4 EFIS: 0719000091 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-210-R0.0/R9.7
Work Description: PLACE CONCRETE PAVEMENT, BARRIER, HMA, DRAINAGE, AND ELECTRICAL.
Location Description: LOS ANGELES COUNTY IN LOS ANGELES FROM INTERSTATE 5 TO WHEATLAND AVENUE UNDERCROSSING
Contractor Name: FLATIRON WEST INC
Contractor Address: 15335 FAIRFIELD RANCH ROAD, CHINO HILLS, CA 91709
Resident Engineer: Ridwan Salman Structure Rep.: Adriana Pimienta

Sample Information

DIME Sample ID: 2021-11-06-3
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Material Lab, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Acceptance
Type of Material: Soil
Sample Taken Date: 11/06/2021
Date that the sample was received by the laboratory/organization performing the testing: 11/06/2021
The quantity of what the sample constitutes: 713 sy
A brief description of the sample: EB210 Polk St. on ramp sta. 167+82-172+95
From where was the sample collected: Job Site
Laboratory sample identification: 21-2725
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Flatiron

Material Information

The fabricator's/manufacturer's product name for the sample: Flatiron
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: EB210 Polk St. on ramp
Where the material sample would have been placed if not sampled:

Test Results

Test 1 of 2

DIME Test ID: 2021-11-06-3-1
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 - Material Lab, Unit 1953
Organization Address: 1940 S. Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email:
Organization Phone: (213) 817-0387
Data has not been verified.

Test 2 of 2

DIME Test ID: 2021-11-06-3-2
Test Method: CTM 216-June 2011: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates
Submitted By Organization: CT D07 - Material Lab, Unit 1953
Organization Address: 1940 S. Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email:
Organization Phone: (213) 817-0387
Data has not been verified.

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.