Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 77777 DEA: CHEM-STOCK EFIS: CHEM-STOCK
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for Chem Lab stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2026-01-15-84
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 Control
Type of Material: Paint
Sample Taken Date: 01/15/2026
Date that the sample was received by the laboratory/organization performing the testing: 01/15/2026
The quantity of what the sample constitutes: 1 QT CAN
A brief description of the sample: BRIDGE# 53-1039, TAYLOR OVERPASS D7, COLOR #26622 LT. GRAY
From where was the sample collected: Manufacturer
Laboratory sample identification: C260049
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Stiles Paint
Batch Number: 459126
Color: LT GRAY
Batch size: 150 GAL
Date of Manufacturing: 0000-00-00
Paint Specification: PWB 174
Paint Specification Version: A
