Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000267 DEA: 070W6404 EFIS: 0722000357
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-2,134,170-Var
Work Description: METHACRYLATE, POLYESTER OVERLAY, SPILL REPAIR AND JOINT SEALS.
Location Description: LOS ANGELES COUNTY AT VARIOUS LOCATIONS
Contractor Name: TRUESDELL CORPORATION OF CALIFORNIA, INC.
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2024-10-18-4
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Acceptance
Type of Material: Polyester
Sample Taken Date: 10/18/2024
Date that the sample was received by the laboratory/organization performing the testing: 10/18/2024
The quantity of what the sample constitutes: 30 CY
A brief description of the sample: Polyester Overlay
From where was the sample collected: Job Site
Laboratory sample identification: 24-3245
Structure unique identifier: 53-1285
Structure name: Los Angeles River Bridge
The fabricator/manufacturer/facility name: NA
DIME Test ID: 2024-10-18-4-1
Test Method: CTM 552-December 2013: Method of Test for Relative Compaction of Polymer Concrete Utilizing Nuclear Gages
Verified Date: 10/18/2024
Date Tested: 10/18/2024
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 407-6963
General Comments for this Test: WB Rte. 134 LA River Bridge
Bridge No. 53-1285
Test Result Compliance:
Additional Comments When Verified:
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Gage No.
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31105
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Time of test
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01:00 HH:MM
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Standard Density
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2.23 g/cc
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In-Place Density
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2.62 g/cc
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Percent Relative Compaction
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117 %
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