Sample Record

Owner Lab

  • T.P.A Construction Incorporated

DIME Sample ID 2023-08-25-57

Project Information

Project IdentifiersProject ID: 993662
DEA: 061A6404
EFIS: 0620000176
DIST-CO-RTE-PM06-FRE-41,180-R23.1,R58.7
Award Date05/20/2022
Closeout Date04/24/2024
Work DescriptionPLACE POLYESTER CONCRETE OVERLAY AND REPLACE JOINT SEAL ASSEMBLY.
Location DescriptionFRESNO COUNTY IN FRESNO ON ROUTE 41 AT VENTURA AVENUE VIADUCT AND ON ROUTE 180 AT ROUTE 180/41 CONNECTOR SEPARATION
QA Service Level1 (Verified on 04/04/2022)

Sample Information

Sample Taken Date08/25/2023 Sample Unique Key57
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing08/25/2023
Sample typeInformational A brief description of the sampleCTS Rapid Set Cement
The quantity of what the sample constitutes1 bag From where was the sample collectedSupplier
First name of sampler or witnessed byPavel Last name of sampler or witnessed byTyukayev
Title of samplerPresident Telephone number of sampler9169191624
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCTS Inc Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeRapid Set ManufacturerCTS Cement Manufacturing Corporation
Mix no.225082523D Materials ReceivedYes
Lot no.225082523D Batch no.225082523D

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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