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Testing Report for 2014-06-13-10006496-2

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

Project Information

DEA: 07121844
EFIS: 0700000117
Project ID: 3807
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-42.8/47.3
Work Description: CONSTRUCT HOV LANES, RETAINING WALLS AND SOUND WALLS.
Location Description: LOS ANGELES COUNTY IN LOS ANGELES, GLENDALE, AND BURBANK FROM ROUTE 5/134 SEPARATION TO MAGNOLIA BOULEVARD OVERCROSSING
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: James Shih
Structure Rep.: Matthew Remo

Sample Information

DIME Sample ID: 2014-06-13-10006496
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: 6/13/2014
Date that the sample was received by the laboratory/organization performing the testing: 6/13/2014
The quantity of what the sample constitutes: 1 Bucket
A brief description of the sample: Structure Backfill
From where was the sample collected: Other
Laboratory sample identification: 4164B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Various locations at subgrade.

Material Information

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: From various locations at subgrade.
Where the material sample would have been placed if not sampled:

Test Information

DIME Test ID: 2014-06-13-10006496-2
Test Method: CTM 217-June 2011: Method of Test for Sand Equivalent
Date Tested: 6/16/2014
Verified Date: 2/20/2015
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:
Test Result Compliance: comply
Additional Comments When Verified :

Submitted Test Results

Number of tests: 1
Sand equivalent after temperature correction: 31