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Testing Report for 2014-04-17-8000370-2

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

Project Information

DEA: 07121844
EFIS: 0700000117
Project ID: 3807
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-42.8/47.3
Work Description: CONSTRUCT HOV LANES, RETAINING WALLS AND SOUND WALLS.
Location Description: LOS ANGELES COUNTY IN LOS ANGELES, GLENDALE, AND BURBANK FROM ROUTE 5/134 SEPARATION TO MAGNOLIA BOULEVARD OVERCROSSING
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: James Shih
Structure Rep.: Matthew Remo

Sample Information

DIME Sample ID: 2014-04-17-8000370
TL Number from the TL Form:
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Acceptance
Type of Material: Soil
Sample Taken Date: 4/17/2014
Date that the sample was received by the laboratory/organization performing the testing: 4/23/2014
The quantity of what the sample constitutes: 2 Bags
A brief description of the sample: Structure Backfill
From where was the sample collected: Source
Laboratory sample identification: 4131B
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: MSE Wall E Sta. 10 30 at 168.50

Material Information

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: MSE Wall E Sta. 10 30 at 168.50 Inspection Element Level
Where the material sample would have been placed if not sampled:

Test Information

DIME Test ID: 2014-04-17-8000370-2
Test Method: CTM 643-June 2007: Method for Determining Field and Laboratory Resistivity and pH Measurements for Soil and Water
Date Tested: 4/27/2014
Verified Date: 11/19/2014
Submitted By Organization: CT - Southern Regional Laboratory
Organization Address: 13970 Victoria St,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 213-792-4794
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

No reportable test results have been submitted for this test.