Project Information

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

Sample Information

DIME Sample ID: 2022-10-26-51

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: Quality Assurance

Type of Material: Aggregate

Sample Taken Date: 10/26/2022

Date that the sample was received by the laboratory/organization performing the testing: 10/26/2022

The quantity of what the sample constitutes: 17334 sq. ft.

A brief description of the sample: Aggregate Base

From where was the sample collected: Job Site

Laboratory sample identification: 22-2890

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: n/a

Material Information

Source Identification (SMARA, name of Pit or Job Site): n/a

The fabricator's/manufacturer's product name for the sample:

The fabricator/manufacturer designation for the sample:

The plant number:

A detailed description of where the material sample was collected: CTM 231 Test Holes

Where the material sample would have been placed if not sampled:

Primary Aggregate Nominal Size: 3/8 inch

The concrete mix design number:

Lot number:

Sublot number:

Aggregate Mix Number:

Test Results

Test 1 of 2

DIME Test ID: 2022-10-26-51-1

Test Method: CTM 231-March 2013: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates Using Nuclear Gages

Verified Date: 11/04/2022

Date Tested: 10/26/2022

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

General Comments for this Test:

Test Result Compliance: does not comply

Additional Comments When Verified:

Standard Count Density	2117 g/cc
Count or Density 1	3217 g/cc
Count or Density 2	2701 g/cc
Count or Density 3	2883 g/cc
Count or Density 4	2035 g/cc
Count or Density 5	2403 g/cc
Standard Count Moisture	714 g/cc
Moisture Count 1	108 g/cc
Moisture Count 2	117 g/cc
Moisture Count 3	121 g/cc
Moisture Count 4	191 g/cc
Moisture Count 5	125 g/cc
Sum of Count or Density	13239.00 g/cc
Average of Count or Density	2648.00 g/cc
Sum of Moisture Count	662.00 g/cc
Average of Moisture Count	132.00 g/cc
Count Ratio Density	1.25
Count Ratio Moisture	0.18
Calculated Percent Relative Compaction	90.2 %
Reported Percent Relative Compaction	90 %

Test 2 of 2

DIME Test ID: 2022-10-26-51-2

Test Method: CTM 216-June 2011: Method of Test for Relative Compaction of Untreated and Treated Soils and Aggregates