Print Test 643
STATE OF CALIFORNIA ● DEPARTMENT OF TRANSPORTATION
SAMPLE IDENTIFICATION CARD
TL-0101 (REV. 02/17)
DIME Sample ID:
FIELD NO.
DIST LAB NO.
LOT NO.
P.O. OR REQ. NO.
TEST TYPE:
SHIPMENT NO.
AUTHORIZATION NO.
SAMPLE SENT TO:
HDQRS. LAB
BRANCH LAB
DIST. LAB
TRANS. LAB
SAMPLE OF:
FOR USE IN:
SAMPLE FROM:
DEPTH:
LOCATION OF SOURCE:
SAMPLES REPRESENTING (TONS, GALS, BBLS, STA, ETC.)
AND IS ONE OF A GROUP OF
THIS SAMPLE IS SHIPPED IN(NO. CONTAINERS)
OWNER OR MANUFACTURER:
DATE NEEDED
TEST RESULTS DESIRED
NORMAL PRIORITY
NORMAL PRIORITY
TOTAL QUANTITY AVAILABLE
REMARKS:
DATE SAMPLED:
BY:
TITLE:
DIST, CO, RTE, PM:
CONT. NO.:
FED. NO.:
LIMITS:
RECIPIENT(S):
(to be selected by data publishing engineer)
CONTRACTOR:
Corrosion Test No.
EA:
Tested By:
Date:
Total Water Added
(milliliters)
Soil
Sample
Resistance
Sample
Resistance
(Ohms)
Minimum Soil Resistance, R
min-T
R
min-T =
__________
(Ohms)
Resistance of Water, RT
RT =
__________
(Ohms)
Sample
Temperature, T
Temperature, T
T =
_____
°C
Minimum Resistance of soil sample corrected
to 15.5°C, Rmin-15.5
to 15.5°C, Rmin-15.5
Rmin-15.5 = Rmin-T(24.5+T)
40
40
Rmin-15.5 =
__________
(Ohms)
Minimum Soil Resistivity, ρmin-15.5
ρmin-15.5 = Rmin-15.5 × (Soil Box Constant = ___
)
ρmin-15.5 =
__________
(Ohm-cm)
Resistance of water sample corrected
to 15.5°C, R15.5
to 15.5°C, R15.5
R15.5 = RT(24.5+T)
40
40
R15.5 =
__________
(Ohms)
Resistivity of Water Sample, ρ15.5
ρ15.5 = R15.5 × (Soil Box Constant = ___
)
ρ15.5 =
__________
(Ohm-cm)
pH Value
SoilWater
pH = __________
pH = __________