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Sample Record for 2013-09-13-8000550

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

Project Information

Project ID: 3770 DEA: 07117074 EFIS: 0700000083 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-10-50.2/53.4
Work Description: Construct HOV Lanes, Retaining Walls And Sound Walls
Location Description:
Contractor Name: FLATIRON WEST INC
Contractor Address: 1770 LA COSTA MEADOWS DRIVE, SAN MARCOS CA 92078
Resident Engineer: Sherif Botros Structure Rep.: EL_ZAYNAB, ALI

Sample Information

DIME Sample ID: 2013-09-13-8000550
TL Number from the TL Form:
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Annual Source Testing
Type of Material: Aggregate
Sample Taken Date: 09/13/2013
Date that the sample was received by the laboratory/organization performing the testing: 09/13/2013
The quantity of what the sample constitutes: 8 Bags
A brief description of the sample: 1-1/2 Rock
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Robertsons Rialto

Material Information

Source Identification (SMARA or name of Pit): SMARA No. 91-36-0146
The fabricator's/manufacturer's product name for the sample: 1-1/2 Rock
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Stockpile
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1-1/2 inch
The concrete mix design number:
Lot number:
Sublot number:

Test Results

Test Information 3 of 5

DIME Test ID: 2013-09-13-8000550-3
Test Method: CTM 211-May 2010: Abrasion of Coarse Aggregate by Use of the Los Angeles Abrasion Testing Machine
Verified Date: 11/19/2014
Date Tested: 09/17/2013
Submitted By Organization: CT - Southern Regional Laboratory
Organization Address: 13970 Victoria St,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 213-792-4794
General Comments for this Test:
Additional Comments When Verified:
Grading A
Percent wear 26 %

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.