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Sample Record for 2024-09-05-90

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 1000225 DEA: 023J3204 EFIS: 0222000034 QA Service Level: 1
DIST-CO-RTE-PM: 02-TRI-3,36,299-Var
Work Description: BRIDGE POLYESTER CONCRETE OVERLAY & METHACRYLATE DECK SEAL.
Location Description: TRINITY COUNTY AT VARIOUS LOCATIONS
Contractor Name: Q&D CONSTRUCTION, LLC
Contractor Address: Unknown
Resident Engineer: Edward Worden Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2024-09-05-90
TL Number from the TL Form: 636957
Sample Submitted By Organization: CT HQ - Sacramento Concrete Testing Laboratory
Sample Organization Contact: (916) 206-4373
Type of Sample: Quality Assurance
Type of Material: Polyester
Sample Taken Date: 09/05/2024
Date that the sample was received by the laboratory/organization performing the testing: 09/13/2024
The quantity of what the sample constitutes: 1
A brief description of the sample: 1 gallon can
From where was the sample collected: Other
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: KBP

Material Information

Mfg. Lot Number(s): AZ4F00876T
Batch number: AZ4F00876T
Mix number: 3862
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2024-09-05-90-1
Test Method: ASTM D2196-Feb15: Standard Test Methods for Rheological Properties of Non-Newtonian Materials by Rotational Viscometer
Verified Date: 09/23/2024
Date Tested: 09/13/2024
Submitted By Organization: CT HQ - Sacramento Concrete Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joe.harline@dot.ca.gov
Organization Phone: (916) 206-4373
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Viscosity 96.5

Test 2 of 3

DIME Test ID: 2024-09-05-90-2
Test Method: ASTM D1475-Nov13: Standard Test Method For Density of Liquid Coatings, Inks, and Related Products
Verified Date: 09/23/2024
Date Tested: 09/13/2024
Submitted By Organization: CT HQ - Sacramento Concrete Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joe.harline@dot.ca.gov
Organization Phone: (916) 206-4373
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Density Units pounds/gallons
Liquid Density (pounds per gallon) 9

Test 3 of 3

DIME Test ID: 2024-09-05-90-3
Test Method: ASTM D2369-Jul10: Standard Test Method for Volatile Content of Coatings
Verified Date: 09/23/2024
Date Tested: 09/13/2024
Submitted By Organization: CT HQ - Sacramento Concrete Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joe.harline@dot.ca.gov
Organization Phone: (916) 206-4373
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Mean of two volatile content determination 45.72