Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214341 DEA: 081J2004 EFIS: 0817000237
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-R21.5/R22.0
Work Description: EXTEND DECELARATION LANE
Location Description: SAN BERNARDINO COUNTY NEAR HESPERIA FROM 0.1 MILE NORTH OF ROUTE 15/138 SEPARATION TO GISH OVERHEAD
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 13170 TELFAIR AVE, SYLMAR, CA, 91342
Resident Engineer: Shaun Loza Structure Rep.: Ravinder Singh
DIME Sample ID: 2019-05-14-9
TL Number from the TL Form: S-17300-1
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Per Request
Type of Material: Soil
Sample Taken Date: 05/14/2019
Date that the sample was received by the laboratory/organization performing the testing: 06/12/2019
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: Soil
From where was the sample collected: Job Site
Laboratory sample identification: 8609
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Caltrans
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: R-19-002, I-15 SB, PM 21.5-22.0
Where the material sample would have been placed if not sampled: Unknown
DIME Test ID: 2019-05-14-9-2
Test Method: CTM 204-June 2010: Method of Test for Liquid Limit, Plastic Limit and Plasticity Index of Soils (Plasticity Index)
Verified Date: 09/20/2019
Date Tested: 06/15/2019
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance: not applicable
Additional Comments When Verified:
Plastic Index(PI)
|
7
|
Liquid Limit (LL)
|
29 %
|
Plastic Limit (PL)
|
19 %
|