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Sample Record for 2017-03-21-2

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

Project Information

Project ID: 211504 DEA: 060N9904 EFIS: 0612000114 QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE,MAD-41U-33.1/33.4,0.0/0.3
Work Description: BRIDGE SCOUR MITIGATION, SEISMIC RETROFIT AND UPGRADE RAIL.
Location Description: FRESNO AND MADERA COUNTIES NEAR FRESNO FROM 0.1 MILE NORTH OF PERRIN ROAD UNDERCROSSING TO 0.1 MILE SOUTH OF AVENUE 9 UNDERCROSSING
Contractor Name: Viking Construction
Contractor Address: 11315 SUNRISE GOLD CIR. #A, RANCHO CORDOVA CA 95742
Resident Engineer: Mark Mengoni Structure Rep.: ML Bloom

Sample Information

DIME Sample ID: 2017-03-21-2
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: Polyester
Sample Taken Date: 03/21/2017
Date that the sample was received by the laboratory/organization performing the testing: 03/21/2017
The quantity of what the sample constitutes: 80 drums
A brief description of the sample: 1 gallon can
From where was the sample collected: Source
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Kwik bond and Reichhold

Material Information

Mfg. Lot Number(s): 1039800
Batch number: 1039800
Mix number: 1039800

Test Results

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.