Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002106 DEA: 101T4804 EFIS: 1025000009
QA Service Level: 1
DIST-CO-RTE-PM: 10-UNKNOWN--unknown
Work Description:
Location Description:
Contractor Name: TRUESDELL CORP OF CALIFORNIA INC
Contractor Address: 1310 W 23RD STREET, TEMPE AZ 85282
Resident Engineer: Anwar Tofael Structure Rep.: Unknown
DIME Sample ID: 2026-05-29-59
TL Number from the TL Form:
Sample Submitted By Organization: Future Labs, LLC
Sample Organization Contact:
Type of Sample: Quality Assurance
Type of Material: High Friction Surface Treatment
Sample Taken Date: 05/29/2026
Date that the sample was received by the laboratory/organization performing the testing: 06/02/2026
The quantity of what the sample constitutes: 2 Gallons
A brief description of the sample: HFST
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Sika
