Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994612 DEA: 112N1414 EFIS: 1121000253
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-15,78-Various
Work Description: PLACE METHACRYLATE, POLYESTER CONCRETE, JOINT SEALS AND REPAIR SPALLS.
Location Description: SAN DIEGO COUNTY AT VARIOUS LOCATIONS
Contractor Name: TRUESDELL CORPORATION OF CALIFORNIA
Contractor Address: 1310 W 23RD ST, TEMPE AZ 85282
Resident Engineer: Benjamin Haney Structure Rep.: Unknown
DIME Sample ID: 2023-11-06-48
TL Number from the TL Form:
Sample Submitted By Organization: Sika Corporation
Sample Organization Contact: (562) 941-0231
Type of Sample: Per Request
Type of Material: Rapid Set
Sample Taken Date: 11/06/2023
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 2 bags
A brief description of the sample: Rapid Setting Mortar
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Sika - Riverside
