Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 99999 DEA: 0322222
QA Service Level:
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Michael Maksimovich Structure Rep.: Unknown
DIME Sample ID: 2025-03-21-33
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Chemistry Laboratory
Sample Organization Contact: (916) 227-7912
Type of Sample: Quality Assurance
Type of Material: Paint
Sample Taken Date: 03/21/2025
Date that the sample was received by the laboratory/organization performing the testing: 03/26/2025
The quantity of what the sample constitutes: 1 qt can
A brief description of the sample: W.B. TRAFFIC PAINT, PTWB-01
From where was the sample collected: Manufacturer
Laboratory sample identification: C250382
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Ennis-Flint
Batch No.: CP2503Y0328
Color: yellow
Batch size: 1270 gal
Date of Manufacturing: 2025-03-21
Paint Specification: PTWB-01R2
Paint Specification Version: Not Applicable
DIME Test ID: 2025-03-21-33-1
Test Method: CHEMLP 15- : Pass (based on previous testing)
Submitted By Organization: CT HQ - Sacramento Chemistry Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: sanchita.dey@dot.ca.gov
Organization Phone: (916) 227-7912
Data has not been verified.
