Sample Record

Owner Labs

  • CT - Unassigned/General Field Laboratory
  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2019-03-14-5

Project Information

Project IdentifiersProject ID: 209695
DEA: 08347704
EFIS: 0800000616
Award Date11/10/2017
Closeout Date01/14/2021
Work Description(Alternative Delivery) The CMGC project will upgrade SR 58 from 2- to 4-lanes in San Bernardino County from the Kern County line to 7.5 miles east of US-395.
Location DescriptionSR-58 / 395 Kramer Junction project. In San Bernardino County from the Kern County line to 7.5 miles east of US-395.
QA Service Level1 (Verified on 12/01/2017)

Sample Information

Sample Taken Date03/14/2019 Sample Unique Key5
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 testingNot set
Sample typeQuality Assurance A brief description of the sampleMethacrylate components
The quantity of what the sample constitutes55 gallons From where was the sample collectedJob Site
First name of sampler or witnessed byGary Last name of sampler or witnessed byMaComb
Title of sampler Telephone number of sampler5624498001
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameKwikBond Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL10-002-19 Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeMethacrylate Mfg. Lot Number(s)18-70-789888, 18-410, CHP
Batch number0 Mix numbernot mixed

Submitted Tests

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

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Test File Attachments