Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 3807 DEA: 07121844 EFIS: 0700000117
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: SECURITY PAVING COMPANY, INC.
Contractor Address: 13170 TELFAIR AVENUE, SYLMAR, CA 91342
Resident Engineer: James Shih Structure Rep.: Matthew Remo
DIME Sample ID: 2014-03-06-14007726
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Department Acceptance
Type of Material: Soil
Sample Taken Date: 03/06/2014
Date that the sample was received by the laboratory/organization performing the testing: 03/14/2014
The quantity of what the sample constitutes: 2 Bags
A brief description of the sample: Structure Backfill
From where was the sample collected: Other
Laboratory sample identification: 4107B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: MSE Wall C Sta. 11 20.
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: MSE Wall C Sta. 11 20.
Where the material sample would have been placed if not sampled:
DIME Test ID: 2014-03-06-14007726-2
Test Method: CTM 643-June 2007: Method for Determining Field and Laboratory Resistivity and pH Measurements for Soil and Water
Verified Date: 02/20/2015
Date Tested: 03/21/2014
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: (909) 829-3029
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Oops.. looks like no test results have been submitted for the test.
