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Sample Record for 2020-08-13-10

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

Project Information

Project ID: 214799 DEA: 031G4804 EFIS: 0318000240 QA Service Level: 1
DIST-CO-RTE-PM: 03-NEV,PLA,SIE-49,80-VAR
Work Description: REPLACE POLYESTER CONCRETE OVERLAY ON BRIDGES.
Location Description: NEVADA, PLACER, AND SIERRA COUNTIES AT VARIOUS LOCATIONS
Contractor Name: Myers and Sons
Contractor Address: 4600 NORTHGATE BLVD, STE 100, SACRAMENTO, CA 95834
Resident Engineer: Carl Anderson Structure Rep.: Carl Anderson

Sample Information

DIME Sample ID: 2020-08-13-10
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: 08/13/2020
Date that the sample was received by the laboratory/organization performing the testing: 08/13/2020
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): 1271783
Batch number: 1271783
Mix number: 1271783

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.