Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214451 DEA: 07303704 EFIS: 0714000035
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-101-8.0/27.3
Work Description: REPLACE CONCRETE BARRIERS.
Location Description: THE CITY AND COUNTY OF LOS ANGELES FROM PILGRIMAGE OVERCROSSING TO VALLEY CIRCLE BOULEVARD OVERCROSSING
Contractor Name: OHL USA
Contractor Address: 1920 Main Street, Suite 310, Irvine, California 92614
Resident Engineer: Kevin Bui Structure Rep.: Kwangsuk Suh
DIME Sample ID: 2023-05-09-84
TL Number from the TL Form:
Sample Submitted By Organization: Alta Vista Solutions - Whittier
Sample Organization Contact: (510) 542-9827
Type of Sample: Quality Assurance
Type of Material: Soil
Sample Taken Date: 05/09/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/09/2023
The quantity of what the sample constitutes: 2400 sqft
A brief description of the sample: Subgrade
From where was the sample collected: Job Site
Laboratory sample identification: 23-0568
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: n/a
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: CTM 231 Test Holes
Where the material sample would have been placed if not sampled:
