Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215677 DEA: 044G0804 EFIS: 0412000332 COOP: 042676
QA Service Level: 1
DIST-CO-RTE-PM: 04-SOL-80-R10.4/30.2
Work Description: Highway widening, overhead signs, and electronic toll system.
Location Description: In Solano County in Fairfield and Vacaville from 1.0 mile west of Red Top Road Undercrossing to 0.4 mile east of Leisure Town Road Overcrossing.
Contractor Name: O.C. JONES & SONS, INC.
Contractor Address: 1520 Fourth Street, Berkeley, CA 94710
Resident Engineer: Justen Tatum Structure Rep.: Kelsey Littell
DIME Sample ID: 2024-06-21-53
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Concord Field Laboratory
Sample Organization Contact: (510) 714-7019
Type of Sample: Quality Assurance
Type of Material: Soil
Sample Taken Date: 06/21/2024
Date that the sample was received by the laboratory/organization performing the testing: 06/20/2024
The quantity of what the sample constitutes: STA. 00+05 to 00+15
A brief description of the sample: Abutment 1
From where was the sample collected: Job Site
Laboratory sample identification: Con_24_464
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Lake Herman Quarry
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: Abutment 1
Where the material sample would have been placed if not sampled:
