Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993705 DEA: 11056394 EFIS: 1117000151
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-11-2.7
Work Description: CONSTRUCT DRAINAGE FACILITIES, RETAINING WALL AND EARTHWORK.
Location Description: SAN DIEGO COUNTY NEAR SAN DIEGO AT 1.9 MILES EAST OF SANYO AVENUE UNDERCROSSING.
Contractor Name: Ral Investment Corporation
Contractor Address: 10065 Old Grove Rd Ste 200, San Diego, CA, 92131-1664
Resident Engineer: Michael Charak Structure Rep.: Victor Yoon
DIME Sample ID: 2022-11-28-26
TL Number from the TL Form:
Sample Submitted By Organization: CT D11 - South County/Trade Corridor FO
Sample Organization Contact: 6197607875
Type of Sample: Quality Assurance
Type of Material: Soil
Sample Taken Date: 11/28/2022
Date that the sample was received by the laboratory/organization performing the testing: 11/28/2022
The quantity of what the sample constitutes: 1 Bag
A brief description of the sample: Lean Clay (CL) Dark Brown
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Imported soils to SP-2
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: NW Quadrant
Where the material sample would have been placed if not sampled:
