Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215211 DEA: 051K6904 EFIS: 0518000230
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-1,101,154-VAR
Work Description:
Location Description:
Contractor Name: Myers & Sons Construction
Contractor Address: 4600 Northgate Boulevard, Suite 100, Sacramento, CA 95834-1121
Resident Engineer: David Ballentine Structure Rep.: David Lewis
DIME Sample ID: 2021-02-05-28
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: 02/05/2021
Date that the sample was received by the laboratory/organization performing the testing: 02/05/2021
The quantity of what the sample constitutes: 25000 gallons
A brief description of the sample: 1 Quart bottle
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Kwik Bond Polymers, Benicia
DIME Test ID: 2021-02-05-28-1
Test Method: CONCLP 4-16: HMWM
Verified Date: 05/28/2021
Date Tested: 05/28/2021
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 SSD Bond Strength and Tack Free Time based on Vendors 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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19.6
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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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23.2
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Flash point (ASTM D 3828) more than 180 deg F
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205
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PCC - SSD bond strength (CA Test 551) 500 psi minimum @ 24 hours
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888
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Tack free time, 400 minutes max
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260
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