Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214524 DEA: 07304504 EFIS: 0714000067
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-57-R0.0/R4.5
Work Description: CONCRETE PAVEMENT, CONCRETE BARRIER, AND ELECTRICAL WORK.
Location Description: LOS ANGELES COUNTY IN DIAMOND BAR AND CITY OF INDUSTRY FROM ORANGE COUNTY LINE TO ROUTE 57/60 SEPARATION
Contractor Name: Griffith Company
Contractor Address: 3050 E. Birch Street, Brea, CA 92821
Resident Engineer: Martin Sandoval Structure Rep.: Avtar Bains
DIME Sample ID: 2021-11-08-1
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: 11/08/2021
Date that the sample was received by the laboratory/organization performing the testing: 11/08/2021
The quantity of what the sample constitutes: 2000 cy
A brief description of the sample: Class 3 Aggregate Base
From where was the sample collected: Job Site
Laboratory sample identification: 21-2737
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Griffith construction
The fabricator's/manufacturer's product name for the sample: class 3 AB
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: NB Rte 57 DS 46
Where the material sample would have been placed if not sampled:
DIME Test ID: 2021-11-08-1-1
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.
DIME Test ID: 2021-11-08-1-2
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.
