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Sample Record for 2019-01-01-8

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

Project Information

Project ID: 9999 DEA: 00000000 EFIS: 0000000000 COOP: 99999333399 MINOR: 333333 Permit Numbers: 555555 0400NRT0000 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: YYZ
Contractor Address: 1234 address, Sacramento, CA 95824
Resident Engineer: RE_first RE_last Structure Rep.: SR_First SR_Last

Sample Information

DIME Sample ID: 2019-01-01-8
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Sample Organization Contact: (562) 500-5861
Type of Sample: Verification
Type of Material: Polyester
Sample Taken Date: 01/01/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 1
A brief description of the sample: a
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: a

Material Information

Mfg. Lot Number(s): 12
Batch number: 1
Mix number: 12
Test results on following page(s): 4

Test Results

Test 1 of 4

DIME Test ID: 2019-01-01-8-1
Test Method: ASTM D638-Dec14: Standard Test Method for Tensile Properties of Plastics
Verified Date: 02/06/2019
Date Tested: 01/02/2019
Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens tested 1
Conditioning procedure 1
Speed of testing 1 in per min
Sample 1 Width 1 in
Sample 1 Ultimate strength 1 psi
Sample 1 Thickness 1 in
Sample 1 Area 1 in^2
Sample 1 Ultimate Strength Actual 1 psi
Sample 1 percent elongation 1 %
Sample 1 Time 1 minute
Ultimate Strength Average 1 psi
Percent Elongation Average 1 %

Test 2 of 4

DIME Test ID: 2019-01-01-8-2
Test Method: ASTM D638-Dec14: Standard Test Method for Tensile Properties of Plastics
Verified Date: 02/06/2019
Date Tested: 01/03/2019
Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens tested 2
Conditioning procedure 2
Speed of testing 2 in per min
Sample 1 Width 2 in
Sample 1 Ultimate strength 2 psi
Sample 1 Thickness 2 in
Sample 1 Area 2 in^2
Sample 1 Ultimate Strength Actual 2 psi
Sample 1 percent elongation 2 %
Sample 1 Time 2 minute
Sample 2 Width 2 in
Sample 2 Thickness 2 in
Sample 2 Area 2 in^2
Sample 2 Ultimate strength 2 psi
Sample 2 Ultimate Strength Actual 2 psi
Sample 2 percent elongation 2 %
Sample 2 Time 2 minute
Ultimate Strength Average 2 psi
Percent Elongation Average 2 %

Test 3 of 4

DIME Test ID: 2019-01-01-8-3
Test Method: ASTM D2196-Feb15: Standard Test Methods for Rheological Properties of Non-Newtonian Materials by Rotational Viscometer
Verified Date: 02/06/2019
Date Tested: 02/08/2019
Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Viscosity 12

Test 4 of 4

DIME Test ID: 2019-01-01-8-4
Test Method: ASTM D2196-Feb15: Standard Test Methods for Rheological Properties of Non-Newtonian Materials by Rotational Viscometer
Submitted By Organization: CT HQ - QAM Sacramento Field Laboratory
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
Data has not been verified.