Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000653 DEA: 051H6914 EFIS: 0521000065
QA Service Level: 1
DIST-CO-RTE-PM: 05-MON, -101-98.8/100.3
Work Description: INSTALL CULVERTS, CONCRETE BARRRIER AND MGS.
Location Description: MONTEREY COUNTY NEAR PRUNEDALE FROM 0.4 MILE NORTH OF CRAZY HORSE CANYON ROAD TO DUNBARTON ROAD
Contractor Name: PRECISION GRADE, INC.
Contractor Address: Unknown
Resident Engineer: Baljinder Brar Structure Rep.: Unknown
DIME Sample ID: 2026-03-19-75
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: CIPP Resin
Sample Taken Date: 03/19/2026
Date that the sample was received by the laboratory/organization performing the testing: 03/19/2026
The quantity of what the sample constitutes: 1 PINT
A brief description of the sample: INSITUFORM CIPP - DIST 05/BAY AREA
From where was the sample collected: Source
Laboratory sample identification: C260295
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: INSITUFORM, INC
