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Testing Report for 2014-10-05-1-2

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

Project Information

Project ID: 7428 DEA: 07215944 EFIS: 0700001834 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-4.0/5.9
Work Description: RECONSTRUCT AND WIDEN FREEWAY AND UNDERCROSSING STRUCTURES.
Location Description: LOS ANGELES COUNTY IN NORWALK FROM 0.4 MILE SOUTH OF SAN ANTONIO DRIVE UNDERCROSSING TO 0.7 MILE NORTH OF PIONEER BOULEVARD UNDERCROSSING
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Jerome Arabe Structure Rep.: Tsegie, Amare

Sample Information

DIME Sample ID: 2014-10-05-1
TL Number from the TL Form:
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Acceptance
Type of Material: Soil
Sample Taken Date: 10/05/2014
Date that the sample was received by the laboratory/organization performing the testing: 10/07/2014
The quantity of what the sample constitutes: Unknown
A brief description of the sample: Soil for Structure Backfill
From where was the sample collected: Source
Laboratory sample identification: 4281B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: 3rd St off from 710 Northbound

Material Information

The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: 3rd St off from 710 Northbound
Where the material sample would have been placed if not sampled: Unknown

Test Information

DIME Test ID: 2014-10-05-1-1
Test Method: CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates
Verified Date: 02/20/2015
Date Tested: 10/08/2014
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:

Submitted Test Results

Number of tests 1
Sand equivalent after temperature correction 21