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Testing Report for 2020-12-30-10-3

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

DEA: 042K9504
EFIS: 0417000057
Project ID: 215421
QA Service Level: 1
DIST-CO-RTE-PM: 04-SF-101-
Work Description:
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2020-12-30-10
TL Number from the TL Form: C969977
Sample Submitted By Organization: Wood
Sample Organization Contact: (916) 396-3815
Type of Sample: Per Request
Type of Material: Soil
Sample Taken Date: 12/30/2020
Date that the sample was received by the laboratory/organization performing the testing: 1/6/2021
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: soil
From where was the sample collected: Job Site
Laboratory sample identification: CR20210002
Structure unique identifier: 04-ALA-580 PM14.3
Structure name: D4 Mat Lab
The fabricator/manufacturer/facility name: Caltrans

Material Information

The fabricator's/manufacturer's product name for the sample: RW-20-001
The fabricator/manufacturer designation for the sample: Corrosion Testing
A detailed description of where the material sample was collected: 5-10 feet depth
Where the material sample would have been placed if not sampled:

Test Information

DIME Test ID: 2020-12-30-10-3
Test Method: CTM 422-June 2014: Method of Testing Soils and Waters for Chloride Content
Date Tested: 1/27/2021
Verified Date: 2/22/2021
Submitted By Organization: Wood
Organization Address: 9177 Sky Park Court,
Organization City: San Diego
Organization State: CA
Organization Zipcode: 92123
Organization Email:
Organization Phone: (916) 396-3815
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Material type: Soils
Amount of the analyte in the sample: 108