Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000927 DEA: 101R7204 EFIS: 1023000209
QA Service Level: 1
DIST-CO-RTE-PM: 10-SJ-5,99-Var
Work Description: PLACE POLYESTER CONCRETE OVERLAY, TRAFFIC STRIPE, COLD PLANE, AND HMA.
Location Description: SAN JOAQUIN COUNTY AT VARIOUS LOCATIONS
Contractor Name: MCCUEN CONSTRUCTION, INC.
Contractor Address: Unknown
Resident Engineer: David Abledu Structure Rep.: Unknown
DIME Sample ID: 2026-04-09-44
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: Polyester
Sample Taken Date: 04/09/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/10/2026
The quantity of what the sample constitutes: 34 Totes
A brief description of the sample: 1 gallon can / PPC 1121 RESIN
From where was the sample collected: Source
Laboratory sample identification: 000208KBP
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Kwik Bond Polymers, Benicia
