Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214486 DEA: 080K1224 EFIS: 0815000244
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-R28.6/37.5
Work Description: REHBILIATATE EXISTING MAINLINE AND RAMP PAVEMENT
Location Description: SAN BERNARDINO COUNTY IN HESPERIA AND VICTORVILLE FROM OAK HILL ROAD OVERCROSSING TO 0.1 MILE SOUTH OF BEAR VALLEY ROAD OVERCROSSING
Contractor Name: SULLY - MILLER CONTRACTING COMPANY
Contractor Address: 135 S STATE COLLEGE BLVD. 400, BREA, CA 92821
Resident Engineer: Larry J Canuti Structure Rep.: Taghreed Al-khateeb
DIME Sample ID: 2019-11-15-49
TL Number from the TL Form: K-0K122-1
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Preliminary
Type of Material: Soil
Sample Taken Date: 11/15/2019
Date that the sample was received by the laboratory/organization performing the testing: 11/05/2019
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: native soil sample 1-10'
From where was the sample collected: Job Site
Laboratory sample identification: 8888
Structure unique identifier:
Structure name: BULK -1
The fabricator/manufacturer/facility name: Unknown
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: ON SITE
Where the material sample would have been placed if not sampled: Unknown
DIME Test ID: 2019-11-15-49-1
Test Method: CTM 643-June 2007: Method for Determining Field and Laboratory Resistivity and pH Measurements for Soil and Water
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.
