Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000121 DEA: 041Q8204 EFIS: 0418000341
QA Service Level: 1
DIST-CO-RTE-PM: 04-SF-101-
Work Description: SF 101-Roadway Rehab 3R
Location Description: Route 101 in San Francisco County
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2024-02-07-19
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Control Sample
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 02/07/2024
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 1
A brief description of the sample: Cores retrieved from multiple On- and Off-ramps along Rte. 101 in SF County
From where was the sample collected: Other
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Caltrans
Pavement Surface Type: Other
Type of Traffic Control Provided: Moving Lane Closure
DIST-CO-RTE: 04-SF-101
Direction of Travel:
Post Mile:
Lanes to be Tested: On Ramp,Off Ramp
Station:
