Sample Record

Owner Lab

  • Kwik Bond Polymers

DIME Sample ID 2019-10-08-22

Project Information

Project IdentifiersProject ID: 214117
DEA: 031G5804
EFIS: 0319000043
DIST-CO-RTE-PM03-PLA,NEV-80-68.5/69.8,0.0/13.3
Award Date06/26/2019
Closeout Date03/19/2021
Work DescriptionFURNISH & PLACE POLYESTER CONCRETE INLAY
Location DescriptionPLACER AND NEVADA COUNTIES IN AND NEAR TRUCKEE FROM TROY UNDERCROSSING TO 0.1 MILE EAST OF DONNER PASS OVERCROSSING
QA Service Level1 (Verified on 05/15/2019)

Sample Information

Sample Taken Date10/08/2019 Sample Unique Key22
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing10/08/2019
Sample typeQuality Control A brief description of the sample1 gallon can
The quantity of what the sample constitutes2 Tankers From where was the sample collectedSource
First name of sampler or witnessed byDaniel Last name of sampler or witnessed byTikusis
Title of samplerTechnical Director Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameKwik Bond Polymers and Reichhold Transportation Laboratory (TL) NumberSacramento Caltrans lab
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypePolyester Mfg. Lot Number(s)1208819
Batch number1208819 Mix number1208819

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