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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:
SAMPLE FROM:
FOR USE IN:
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
TOTAL QUANTITY AVAILABLE
REMARKS:
DATE SAMPLE:
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
(Ohms)













Minimum Soil Resistance, R min-T
R min-T =  __________ (Ohms)

Resistance of Water, RT
RT =  __________ (Ohms)
Sample
Temperature, T
T =  _____ °C

Minimum Resistance of soil sample corrected
to 15.5°C,  Rmin-15.5
Rmin-15.5 = Rmin-T(24.5+T)
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
R15.5 = RT(24.5+T)
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 = __________