Sample Record

Owner Lab

  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2020-10-13-18

Sample is locked from editing.

Project Information

Project IdentifiersProject ID: 214903
DEA: 074W5404
EFIS: 0719000003
DIST-CO-RTE-PM07-LA-14,138-VAR
Award DateNot set
Closeout DateNot set
Work DescriptionPOLYESTER CONCRETE OVERLAY, APPLY METHCRYLATE & REPLACE JOINT SEALS.
Location DescriptionLOS ANGELES COUNTY AT VARIOUS LOCATIONS
QA Service LevelNOT VERIFIED

Sample Information

Sample Taken Date10/13/2020 Sample Unique Key18
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 testing10/15/2020
Sample typeAcceptance A brief description of the samplerapid set patching
The quantity of what the sample constitutes2 bags From where was the sample collectedManufacturer
First name of sampler or witnessed byThao Last name of sampler or witnessed byVu
Title of samplerQuality Specialist Telephone number of sampler
Laboratory sample identification20-119 Linked DIME Sample ID
The fabricator/manufacturer/facility namesika corp Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeRapid Set ManufacturerSika Corporation
Mix no.3474 Materials ReceivedSikaquick 2500
Lot no.3005005154 Batch no.10122001W

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