Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215220 DEA: 07210624 EFIS: 0719000068
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,SBD-71-1.8/R4.7&R0.0/R0.2
Work Description: PLACE STRUCTURE CONCRETE RETAINING WALLS & BOX CULVERT AND PLACE JPCP.
Location Description: IN LOS ANGELES AND SAN BERNARDINO COUNTIES IN POMONA AND CHINO HILLS FROM 0.2 MILE SOUTH OF MISSION BOULEVARD OVERCROSSING TO 0.2 MILE OF SAN BERNARDINO COUNTY LINE.
Contractor Name: OHL USA
Contractor Address: 1920 Main Street, Suite 310, Irvine, California 92614
Resident Engineer: Michael Wang Structure Rep.: Amare Tsegie
DIME Sample ID: 2022-08-16-39
TL Number from the TL Form:
Sample Submitted By Organization: Kleinfelder, Incorporated - Los Angeles
Sample Organization Contact: (909) 833-5780
Type of Sample: Quality Assurance
Type of Material: Soil
Sample Taken Date: 08/16/2022
Date that the sample was received by the laboratory/organization performing the testing: 08/16/2022
The quantity of what the sample constitutes: 300 Sq. Ft.
A brief description of the sample: Structure Backfill Material
From where was the sample collected: Job Site
Laboratory sample identification: 22-2135
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Existing Subgrade
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: In-placed material
Where the material sample would have been placed if not sampled:
DIME Test ID: 2022-08-16-39-1
Test Method: CTM 231-March 2013: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates Using Nuclear Gages
Verified Date: 08/22/2022
Date Tested: 08/16/2022
Submitted By Organization: Kleinfelder, Incorporated - Los Angeles
Organization Address: 620 South Magnolia Avenue, Building G,
Organization City: Ontario
Organization State: CA
Organization Zipcode: 91762
Organization Email: mdorsch@kleinfelder.com
Organization Phone: (909) 833-5780
General Comments for this Test: In-place wet density of 2.21 vs maximum wet density of 2.33.
Test Result Compliance:
Additional Comments When Verified:
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Sum of Count or Density
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no data
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Average of Count or Density
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no data
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Sum of Moisture Count
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no data
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Average of Moisture Count
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no data
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Count Ratio Density
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no data
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Count Ratio Moisture
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no data
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Calculated Percent Relative Compaction
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94.8 %
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Reported Percent Relative Compaction
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95 %
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