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Sample Record for 2024-09-05-91

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

Project Information

Project ID: 993360 DEA: 023J2204 EFIS: 0222000021 QA Service Level: 1
DIST-CO-RTE-PM: 02-TEH,TEH/TEH,PLU/PLU,LAS/LAS,SHA/SHA,PLU,LAS,TEH,SHA-32,36,44,189,147,172-0/24.87, 43.95/104, 0/18.42, 0/6, 14.3/19.2, 19.01/71.39, 0/37.25, 8.9/42.3, 0/9.89, 0/1.8, 0/8.92, 0/4.4, 43.95/19.2, 62.69/37.25, 19.01/62.69, 0/21.72, 6/14.3, 0/247.87, 83/19.2
Work Description: Remove hazard trees, erosion control, paving, and drainage repairs in order to restore the facility.
Location Description:
Contractor Name: Terry Hansen Electric
Contractor Address: 6911 Danyeur RD, Readding, Ca 96001
Resident Engineer: Mike Zdenek Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2024-09-05-91
TL Number from the TL Form: 636955
Sample Submitted By Organization: CT HQ - Sacramento Concrete Testing Laboratory
Sample Organization Contact: (916) 206-4373
Type of Sample: Quality Assurance
Type of Material: Methacrylate
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): 24-30-891
Batch number: 2430891
Mix number: 3860
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2024-09-05-91-1
Test Method: CONCLP 4-16: HMWM
Verified Date: 09/23/2024
Date Tested: 09/11/2024
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 (ASTM D 2196) Brookfield RVT with UL adapter, 50 RPM @ 77 deg F, 25 max cps @ 77 deg F 19.8
Specific gravity (ASTM D 1475) 0.90 min @ 77 deg F 1.09
Volatile content (ASTM D 2369) 30% max 19.8
Flash point (ASTM D 3828) more than 180 deg F 210
PCC - SSD bond strength (CA Test 551) 500 psi minimum @ 24 hours no data psi
Tack free time, 400 minutes max no data minutes