Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000026 DEA: 081E3404 EFIS: 0813000215
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-15-15.9/20.3
Work Description: BONDED FIBER MATRIX, MINOR STAMPED CONC, ROCK MULCH & ROCK BLANKET.
Location Description: RIVERSIDE COUNTY IN WILDOMAR AND LAKE ELSINORE FROM 0.4 MILE SOUTH OF BUNDY CANYON ROAD TO 0.5 MILE NORTH OF GRUNDER DRIVE/FRANKLIN STREET
Contractor Name: DIVERSCAPE, INC. DBA DIVERSIFIED LANDSCAPE CO.
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2025-07-15-173
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: 9512323690
Type of Sample: Acceptance
Type of Material: Soil
Sample Taken Date: 07/15/2025
Date that the sample was received by the laboratory/organization performing the testing: 07/15/2025
The quantity of what the sample constitutes: 23.7 kg
A brief description of the sample: Native Subgrade
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CTM 231 TEST LOCATION
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: SB SR-79 near Gilmans Springs Rd, Drainage Inlet, Sta 1757+65
Where the material sample would have been placed if not sampled:
