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Sample Record for 2018-08-13-8

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

Project Information

Project ID: 212888 DEA: 07202124 EFIS: 0700020870 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-710-20.9/24.6
Work Description: PAVEMENT REHABILITATION AND BRIDGE WIDENING
Location Description: LOS ANGELES COUNTY IN AND NEAR BELL, VERNON, AND CITY OF COMMERCE, FROM 0.2 MILE SOUTH OF SLAUSON AVENUE OVERCROSSING TO 0.1 MILE NORTH OF THIRD STREET OVERCROSSING
Contractor Name: FLATIRON WEST, INC.
Contractor Address: 15335 Fairfield Ranch Road, Suite 200, Chino Hills, CA 91709
Resident Engineer: Peter Lee Structure Rep.: James Holloway

Sample Information

DIME Sample ID: 2018-08-13-8
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: 08/13/2018
Date that the sample was received by the laboratory/organization performing the testing: 08/13/2018
The quantity of what the sample constitutes: 2 tankers
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): 1135684
Batch number: 1135684
Mix number: 1135684

Test Results