Sample Record for 2014-04-28-13002908
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 3958 DEA: 07215914 EFIS: 0700001831
QA Service Level: 1
Work Description: WIDEN AND REALIGN FREEWAY AND RECONSTRUCT OVERCROSSING STRUCTURE.
Location Description: LOS ANGELES COUNTY IN SANTA FE SPRINGS FROM 0.3 MILE SOUTH OF NORTH FORK COYOTE CREEK BRIDGE TO 0.3 MILE NORTH OF MARQUARDT AVENUE AND AT NORWALK HUB AND LOS ANGELES REGIONAL TRANSPORTATION MANAGEMENT CENTER
Contractor Name: C. C. MYERS, INC.
Contractor Address: 3286 Fitzgerald Rd, Rancho Cordova, CA 95742
Resident Engineer: Kelvin Tran Structure Rep.: Dan LaLonde
DIME Sample ID: 2014-04-28-13002908
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Acceptance
Type of Material: Soil
Sample Taken Date: 04/28/2014
Date that the sample was received by the laboratory/organization performing the testing: 05/12/2014
The quantity of what the sample constitutes: 2 Bags
A brief description of the sample: Backfill material
From where was the sample collected: Other
Laboratory sample identification:
Structure unique identifier:
The fabricator/manufacturer/facility name: MSE RW 1 Sta. 106 20 (behind wall).
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: MSE RW 1 Sta. 106 20 (behind wall).
Where the material sample would have been placed if not sampled:
Test 1 of 1
DIME Test ID: 2014-04-28-13002908-2
Test Method: CTM 643-June 2007: Method for Determining Field and Laboratory Resistivity and pH Measurements for Soil and Water
Verified Date: 02/20/2015
Date Tested: 05/16/2014
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: email@example.com
Organization Phone: 213-792-4794
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Tests Assigned to this Sample
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