Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 3825 DEA: 07138204 EFIS: 0700000142
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-47,103-3.5/4.6,0.0/1.1
Work Description: REPLACE STEEL BRIDGE WITH CIP PS CONCRETE BOX GIRDER BRIDGE AND RAMPS.
Location Description: LOS ANGELES COUNTY IN LONG BEACH AND LOS ANGELES ON ROUTE 47 FROM OCEAN BOULEVARD TO ROUTE 103 JUNCTION AND ON ROUTE 103 FROM ROUTE 47 JUNCTION TO ANAHEIM STREET OVERHEAD
Contractor Name: M C M CONSTRUCTION INC
Contractor Address: P O BOX 620, NORTH HIGHLANDS, CA 95660
Resident Engineer: Daniel Leon Structure Rep.: Andy Chen
DIME Sample ID: 2014-01-08-13000035
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: 01/08/2014
Date that the sample was received by the laboratory/organization performing the testing: 01/10/2014
The quantity of what the sample constitutes: 2 Bags
A brief description of the sample: Backfill Material
From where was the sample collected: Source
Laboratory sample identification: 4009B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Jobsite
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: Jobsite
Where the material sample would have been placed if not sampled:
DIME Test ID: 2014-01-08-13000035-1
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: 01/31/2014
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: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
General Comments for this Test:
Test Result Compliance: comply
Additional Comments When Verified:
Oops.. looks like no test results have been submitted for the test.
