Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214352 DEA: 07332704 EFIS: 0716000290
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-18.3
Work Description: APPLY HIGH FRICTION SURFACE TREATMENT, LANDSCAPE, & IRRIGATION WORK.
Location Description: LOS ANGELES COUNTY IN LOS ANGELES ON ROUTE 5
Contractor Name: WESTCOAST PUBLIC WORKS INC
Contractor Address: 20058 VENTURA BLVD, #318;, WOODLAND HILLS CA 91364
Resident Engineer: Sepand Minovi Structure Rep.: Unknown
DIME Sample ID: 2020-07-06-34
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: 07/06/2020
Date that the sample was received by the laboratory/organization performing the testing: 07/06/2020
The quantity of what the sample constitutes: 34 Totes
A brief description of the sample: 1 gallon can
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Kwik Bond Polymers and Reichhold
