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Sample Record for 2022-01-12-22

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 214620 DEA: 07309304 EFIS: 0714000281 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-210,405,605-Various
Work Description: REINFORCE STRUCTURAL CONCRETE BRIDGE AND PLACE RHMA SHOULDER PAVING.
Location Description: LOS ANGELES COUNTY AT VARIOUS LOCATIONS
Contractor Name: Beador Const. Co. Inc.
Contractor Address: 26320 LESTER CIRCLE, CORONA CA 92883
Resident Engineer: MOHAMMAD IZADPANAH Structure Rep.: Richard Joludow

Sample Information

DIME Sample ID: 2022-01-12-22
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: 01/12/2022
Date that the sample was received by the laboratory/organization performing the testing: 01/12/2022
The quantity of what the sample constitutes: 78 cy
A brief description of the sample: Soil for subgrade
From where was the sample collected: Job Site
Laboratory sample identification: 22-0057
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Flatiron

Material Information

The fabricator's/manufacturer's product name for the sample: Subgrade
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: From various locations at subgrade.
Where the material sample would have been placed if not sampled:

Test Results

Test 1 of 2

DIME Test ID: 2022-01-12-22-1
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 S. 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: 2022-01-12-22-2
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 S. 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.