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Sample Record for 2022-01-29-35

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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: 2022-01-29-35
TL Number from the TL Form: 5760
Sample Submitted By Organization: CT D07 - Plant Services
Sample Organization Contact: 562-345-3126
Type of Sample: Department Acceptance
Type of Material: Aggregate
Sample Taken Date: 01/29/2022
Date that the sample was received by the laboratory/organization performing the testing: 02/02/2022
The quantity of what the sample constitutes: 328 CY
A brief description of the sample: LCBRS-Aggregate
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: FCI PCC Portable Plant

Material Information

Source Identification (SMARA, name of Pit or Job Site): Onsite Stockpile
The fabricator's/manufacturer's product name for the sample: LCBRS
The fabricator/manufacturer designation for the sample: FIW110-1
The plant number: Pacoima
A detailed description of where the material sample was collected: Onsite Stockpile
Where the material sample would have been placed if not sampled: LCBRS
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: FIW110-1
Lot number:
Sublot number:
Aggregate Mix Number:

Test Results

Test 1 of 3

DIME Test ID: 2022-01-29-35-1
Test Method: ASTM C136-19: Standard Test Method for Sieve Analysis of Fine and Coarse Aggregates
Verified Date: 03/03/2022
Date Tested: 01/29/2022
Submitted By Organization: CT D07 - Plant Services
Organization Address: 13230 East Firestone Boulevard, Suite G,
Organization City: Santa Fe Springs
Organization State: CA
Organization Zipcode: 90670
Organization Email: victor.zengler@dot.ca.gov
Organization Phone: (562) 345-3126
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
What type of gradation is being tested? Combined Gradation
Cumulative percent passing the 2 in. sieve 0 %
Cumulative percent passing the 1 1/2 in. sieve 0 %
Cumulative percent passing the 1 in. sieve 0 %
Cumulative percent passing the 3/4 in. sieve 96 %
Cumulative percent passing the 1/2 in. sieve 79 %
Cumulative percent passing the 3/8 in. sieve 70 %
Cumulative percent passing the #4 sieve 53 %

Test 2 of 3

DIME Test ID: 2022-01-29-35-2
Test Method: ASTM D2419-09: Standard Test Method for Sand Equivalent Value of Soils and Fine Aggregate
Verified Date: 03/03/2022
Date Tested: 01/29/2022
Submitted By Organization: CT D07 - Plant Services
Organization Address: 13230 East Firestone Boulevard, Suite G,
Organization City: Santa Fe Springs
Organization State: CA
Organization Zipcode: 90670
Organization Email: victor.zengler@dot.ca.gov
Organization Phone: (562) 345-3126
General Comments for this Test: Test was run 2 times only.
Test Result Compliance: complies
Additional Comments When Verified:
Sand Equivalent 42

Test 3 of 3

DIME Test ID: 2022-01-29-35-3
Test Method: ASTM D2419-09: Standard Test Method for Sand Equivalent Value of Soils and Fine Aggregate
Verified Date: 05/31/2022
Date Tested: 02/04/2022
Submitted By Organization: CT D07 - Plant Services
Organization Address: 13230 East Firestone Boulevard, Suite G,
Organization City: Santa Fe Springs
Organization State: CA
Organization Zipcode: 90670
Organization Email: victor.zengler@dot.ca.gov
Organization Phone: (562) 345-3126
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Sand Equivalent 42