Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 77777 DEA: CHEM-STOCK EFIS: CHEM-STOCK
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for Chem Lab stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2024-09-26-29
TL Number from the TL Form: C003284
Sample Submitted By Organization: CT HQ - Sacramento Chemistry Laboratory
Sample Organization Contact: (916) 227-7912
Type of Sample: Preliminary
Type of Material: Soil
Sample Taken Date: 09/26/2024
Date that the sample was received by the laboratory/organization performing the testing: 09/26/2024
The quantity of what the sample constitutes: 130 GRAMS
A brief description of the sample: Soil
From where was the sample collected: Other
Laboratory sample identification: C241558
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Corrosion Lab
The fabricator's/manufacturer's product name for the sample: soil
The fabricator/manufacturer designation for the sample: CR20240401
A detailed description of where the material sample was collected: Corrosion Lab
Where the material sample would have been placed if not sampled:
