Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212151 DEA: 010G9204
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-36-19/44, 3.0/44.0
Work Description: Repair slide near Bridgeville
Location Description:
Contractor Name: Ford Logging, Inc
Contractor Address: 1225 Central ave #11, Mckinleyville, CA 94510
Resident Engineer: Robert King Structure Rep.: Unknown
DIME Sample ID: 2018-02-20-37
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT D01 - District 1 Materials Laboratory
Sample Organization Contact: (707) 496-0974
Type of Sample: Preliminary
Type of Material: Soil
Sample Taken Date: 02/20/2018
Date that the sample was received by the laboratory/organization performing the testing: 07/19/2018
The quantity of what the sample constitutes: 71
A brief description of the sample: calbrl
From where was the sample collected: Job Site
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: n a
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: Unknown
Where the material sample would have been placed if not sampled: Unknown
