Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002398 DEA: 043Y6204 EFIS: 0423000267
QA Service Level: 1
DIST-CO-RTE-PM: 04-SM-380-5.45/6.44
Work Description:
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Chetan Sihra Structure Rep.: Tyler M Pinell
DIME Sample ID: 2026-09-22-27
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: Methacrylate
Sample Taken Date: 09/22/2026
Date that the sample was received by the laboratory/organization performing the testing: 09/22/2026
The quantity of what the sample constitutes: 100 Totes
A brief description of the sample: 2 pints KBP204, CHP, Z-Cure, 8020
From where was the sample collected: Source
Laboratory sample identification: 000227KBP
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Kwik Bond Polymers, Benicia
DIME Test ID: 2026-09-22-27-1
Test Method: CONCLP 4-16: HMWM
Verified Date: 09/30/2026
Date Tested: 09/25/2026
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: Accepted supplier's results.
Test Result Compliance: complies
Additional Comments When Verified:
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Viscosity (ASTM D 2196) Brookfield RVT with UL adapter, 50 RPM @ 77 deg F, 25 max cps @ 77 deg F
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24.6
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Specific gravity (ASTM D 1475) 0.90 min @ 77 deg F
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1.09
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Volatile content (ASTM D 2369) 30% max
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12.78
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Flash point (ASTM D 3828) more than 180 deg F
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249.8
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PCC - SSD bond strength (CA Test 551) 500 psi minimum @ 24 hours
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635
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Tack free time, 400 minutes max
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316
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