Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000312 DEA: 040Y8204 EFIS: 0422000343
QA Service Level: 1
DIST-CO-RTE-PM: 04-SON-101,116,128-Var
Work Description: PLACE POLYESTER CONCRETE OVERLAY, TREAT BRIDGE DECK WITH METHACRYLATE.
Location Description: SONOMA COUNTY AT VARIOUS LOCATIONS
Contractor Name: TRUESDELL CORPORATION OF CALIFORNIA, INC.
Contractor Address: 1310 W 23RD STREET, TEMPE AZ 85282
Resident Engineer: Leonard Brajnikoff Structure Rep.: Alireza "Ali" Jamalipour
DIME Sample ID: 2024-09-20-62
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Concord Field Laboratory
Sample Organization Contact: (510) 714-7019
Type of Sample: Quality Assurance
Type of Material: Polyester
Sample Taken Date: 09/20/2024
Date that the sample was received by the laboratory/organization performing the testing: 09/20/2024
The quantity of what the sample constitutes: 133 SY
A brief description of the sample: Relative Compaction of Polymer Concrete
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Truesdell Corp.
DIME Test ID: 2024-09-20-62-1
Test Method: CTM 552-December 2013: Method of Test for Relative Compaction of Polymer Concrete Utilizing Nuclear Gages
Verified Date: 09/30/2024
Date Tested: 09/30/2024
Submitted By Organization: CT D04 - Concord Field Laboratory
Organization Address: 2525 Stanwell Drive, Suite 100,
Organization City: Concord
Organization State: CA
Organization Zipcode: 94520
Organization Email: gurind.joshi@dot.ca.gov
Organization Phone: (510) 714-7019
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
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Gage No.
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685
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Time of test
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20:00 HH:MM
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Standard Density
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2.4 g/cc
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In-Place Density
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2.47 g/cc
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Percent Relative Compaction
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97 %
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