Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 7427 DEA: 07215934 EFIS: 0700001833
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-2.4/4.0
Work Description: Widen and Realign Freeway and Construct Ped OC, OC and UC Structures.
Location Description: LOS ANGELES COUNTY IN SANTA FE SPRINGS AND NORWALK FROM 0.1 MILE NORTH OF CARMENITA ROAD OVERCROSSING TO 0.1 MILE NORTH OF SILVERBOW AVENUE PEDESTRIAN OVERCROSSING
Contractor Name: FLATIRON WEST INC
Contractor Address: 1770 La Costa Meadows Drive, San Marcos, CA 92078
Resident Engineer: Mashhur Ali Structure Rep.: Steven Kim
DIME Sample ID: 2014-04-22-14002376
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: 04/22/2014
Date that the sample was received by the laboratory/organization performing the testing: 04/23/2014
The quantity of what the sample constitutes: 1 Bag
A brief description of the sample: Structural Backfill Material
From where was the sample collected: Source
Laboratory sample identification: 4132B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: SW 203 appr 15 00 to 19 00 first 3 to 4 ft lift placed behind the wall.
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: SW203 appr 15 00 to 19 00 first 3 to 4 ft lift placed behind the wall.
Where the material sample would have been placed if not sampled:
DIME Test ID: 2014-04-22-14002376-2
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: 04/27/2014
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:
Additional Comments When Verified:
Oops.. looks like no test results have been submitted for the test.
