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Sample Record for 2016-05-20-8

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

Project Information

Project ID: 211208 DEA: 120N9604 EFIS: 1215000014 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-5,90,91,241,405-var
Work Description: METHACRYLIC TREATMENT AND JOINT SEAL REPLACEMENT
Location Description:
Contractor Name: PETERSON-CHASE GENERAL ENGINEERING CONSTRUCTION, INC.
Contractor Address: 1792 KAISER AVENUE, IRVINE, CA 92614
Resident Engineer: Ghassem Ziaeian Structure Rep.: Fran Price

Sample Information

DIME Sample ID: 2016-05-20-8
TL Number from the TL Form: C240495
Sample Submitted By Organization: CT HQ - Sacramento Concrete Testing Laboratory
Sample Organization Contact: (916) 594-1991
Type of Sample: Quality Assurance
Type of Material: Methacrylate
Sample Taken Date: 05/20/2016
Date that the sample was received by the laboratory/organization performing the testing: 05/24/2016
The quantity of what the sample constitutes: 2 pints can
A brief description of the sample: sample for 25000 gallons
From where was the sample collected: Manufacturer
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: kwik Bond, Benecia

Material Information

Mfg. Lot Number(s): 16-061
Batch number: 1606666766
Mix number: 3184
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2016-05-20-8-2
Test Method: ASTM D2369-Jul10: Standard Test Method for Volatile Content of Coatings
Verified Date: 09/18/2018
Date Tested: 06/28/2016
Submitted By Organization: CT HQ - Sacramento Concrete Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: spencer.adams@dot.ca.gov
Organization Phone: (916) 227-5716
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Mean of two volatile content determination 17

Test 2 of 2

DIME Test ID: 2016-05-20-8-3
Test Method: ASTM D3278-Jan96: Standard Test Methods for Flash Point of Liquids by Small Scale Closed-Cup Apparatus
Verified Date: 09/18/2018
Date Tested: 06/28/2016
Submitted By Organization: CT HQ - Sacramento Concrete Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: spencer.adams@dot.ca.gov
Organization Phone: (916) 227-5716
General Comments for this Test: greater than 180
Test Result Compliance: complies
Additional Comments When Verified:
Whether sample flashed and Test Method A was used yes
Mean of duplicate determinations and Test Method B was used no