Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994534 DEA: 010H1604 EFIS: 0117000117
QA Service Level: 1
DIST-CO-RTE-PM: 01-MEN-101-R33.7/R43.2
Work Description: REPLACE AC SURFACING, PLACE HMA-A, RHMA-G & CONCRETE BARRIER.
Location Description: MENDOCINO COUNTY NEAR WILLITS FROM 1.1 MILES NORTH OF WEST ROAD OVERCROSSING TO 0.6 MILE SOUTH OF HAEHL CREEK BRIDGE
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 715 COMSTOCK STREET, SANTA CLARA CA 95054
Resident Engineer: Steve Tisell Structure Rep.: Unknown
DIME Sample ID: 2024-09-23-51
TL Number from the TL Form: Sacramento Caltrans lab
Sample Submitted By Organization: Kwik Bond Polymers
Sample Organization Contact: (760) 518-6064
Type of Sample: Quality Control
Type of Material: High Friction Surface Treatment
Sample Taken Date: 09/23/2024
Date that the sample was received by the laboratory/organization performing the testing: 09/24/2024
The quantity of what the sample constitutes: 2 tankers
A brief description of the sample: 1 gallon can / HFST RESIN
From where was the sample collected: Source
Laboratory sample identification: 000127KBP
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Kwik Bond Polymers, Benicia
