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Sample Record for 2019-08-29-13

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

Project Information

Project ID: 214117 DEA: 031G5804 EFIS: 0319000043 QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA,NEV-80-68.5/69.8,0.0/13.3
Work Description: FURNISH & PLACE POLYESTER CONCRETE INLAY
Location Description: PLACER AND NEVADA COUNTIES IN AND NEAR TRUCKEE FROM TROY UNDERCROSSING TO 0.1 MILE EAST OF DONNER PASS OVERCROSSING
Contractor Name: TRUESDELL CORPORATION OF CALIFORNIA, INC.
Contractor Address: 1310 W 23rd St, Tempe, AZ 85282
Resident Engineer: Randy Stellhorn Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-08-29-13
TL Number from the TL Form:
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: 08/29/2019
Date that the sample was received by the laboratory/organization performing the testing: 08/29/2019
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:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Kwik Bond Polymers and Reichhold

Material Information

Mfg. Lot Number(s): 1201928
Batch number: 1201928
Mix number: 1201928

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.