Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993855 DEA: 060U4604 EFIS: 0615000309
QA Service Level: 1
DIST-CO-RTE-PM: 06-KIN-41-20.0-28.4
Work Description: COLD CENTRAL PLANT RECYCLING, HMA AND HMA-OGFC.
Location Description: KINGS COUNTY NEAR KETTLEMAN CITY FROM 0.1 MILE SOUTH OF QUAIL AVENUE TO NEVADA AVENUE
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 2716 S Granite Ct, Fresno, CA 93706
Resident Engineer: Din Dadawalla Structure Rep.: Unknown
DIME Sample ID: 2022-05-18-52
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Informational
Type of Material: Soil
Sample Taken Date: 05/18/2022
Date that the sample was received by the laboratory/organization performing the testing: 05/19/2022
The quantity of what the sample constitutes: 1 Core Location
A brief description of the sample: Ziploc bag of soil
From where was the sample collected: Job Site
Laboratory sample identification: Sample 29 - Mile 28 900ft
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Soil
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: Core Location 29 - Postmile 28 900 feet CL
Where the material sample would have been placed if not sampled:
