Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 213537 DEA: 010J1704 EFIS: 0118000178
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM,HUM-36-31.40, 31.4
Work Description: Storm Damage Repairs
Location Description: In Humboldt County near Bridgeville 1.2 mile east of McClellan mountain road
Contractor Name: Golden State Bridge, Inc.
Contractor Address: 3701 Mallard Dr., Benicia, CA 94510
Resident Engineer: Joaquin Rodriguez Structure Rep.: Thomas Norris
DIME Sample ID: 2019-06-11-11
TL Number from the TL Form: 971604
Sample Submitted By Organization: CT D01 - District 1 Materials Laboratory
Sample Organization Contact: (707) 496-0974
Type of Sample: Preliminary
Type of Material: Soil
Sample Taken Date: 06/11/2019
Date that the sample was received by the laboratory/organization performing the testing: 06/11/2019
The quantity of what the sample constitutes: ample
A brief description of the sample: native soil sample
From where was the sample collected: Source
Laboratory sample identification: 19-144
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: none
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: Unknown
Where the material sample would have been placed if not sampled: Unknown
DIME Test ID: 2019-06-11-11-2
Test Method: CTM 643-June 2007: Method for Determining Field and Laboratory Resistivity and pH Measurements for Soil and Water
Submitted By Organization: CT D01 - District 1 Materials Laboratory
Organization Address: 1726 Albee Street,
Organization City: Eureka
Organization State: CA
Organization Zipcode: 95501
Organization Email: leif.ayres@dot.ca.gov
Organization Phone: (707) 496-0974
Data has not been verified.
