Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002115 DEA: 09433704 EFIS: 0926000058
QA Service Level: 1
DIST-CO-RTE-PM: 09---unknown
Work Description:
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2026-04-21-33
TL Number from the TL Form:
Sample Submitted By Organization: CT D09 - Bishop Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Production Start-Up
Type of Material: Soil
Sample Taken Date: 04/21/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/21/2026
The quantity of what the sample constitutes: 750 tons
A brief description of the sample: 1 Can of Lime
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Solari Plant
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: Sample Pickup from plant
Where the material sample would have been placed if not sampled:
