Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000610 DEA: 101H3604 EFIS: 1017000185
QA Service Level: 1
DIST-CO-RTE-PM: 10-SJ, -4-
Work Description: PAINT BRIDGE STRUCTURAL STEEL AND PLACE POLYESTER CONCRETE.
Location Description: SAN JOAQUIN COUNTY NEAR DISCOVERY BAY AT OLD RIVER BRIDGE
Contractor Name: DISNEY CONSTRUCTION, INC.
Contractor Address: Unknown
Resident Engineer: Nomer Gutierrez Structure Rep.: Unknown
DIME Sample ID: 2026-04-01-77
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: 04/01/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/07/2026
The quantity of what the sample constitutes: 1 QT CAN
A brief description of the sample: D10/NORTH, OLD RIVER BRIDGE, NON-LEAFING ALUMINUM
From where was the sample collected: Manufacturer
Laboratory sample identification: C260380
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Stiles Paint
Batch Number: 712426
Color: ALUMINUM
Batch size: 180 GAL
Date of Manufacturing: 0000-00-00
Paint Specification: PWB 161
Paint Specification Version: A
