Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214819 DEA: 07288304 EFIS: 0700021024
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-60,60,164,210-Var
Work Description: STORM WATER MITIGATION
Location Description: LOS ANGELES COUNTY AT VARIOUS LOCATIONS
Contractor Name: CHUMO CONSTRUCTION INC
Contractor Address: 14425 Joanbridge St, Baldwin Park, CA 91706
Resident Engineer: Sushilkumar Chaudhari Structure Rep.: Pratheep Piratheepan
DIME Sample ID: 2019-10-21-18
TL Number from the TL Form: A-19-002
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: 10/21/2019
Date that the sample was received by the laboratory/organization performing the testing: 10/29/2019
The quantity of what the sample constitutes: 1 BAG
A brief description of the sample: NATIVE SOIL DEPTH 0-25'
From where was the sample collected: Job Site
Laboratory sample identification: 8792
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Native Material
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: 0 25FT DEPTH NATIVE SOIL
Where the material sample would have been placed if not sampled: Unknown
DIME Test ID: 2019-10-21-18-1
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.
