Sample Record
Owner Lab
- CT HQ - Sacramento Concrete Testing Laboratory
DIME Sample ID 2020-12-11-13
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Project Information
| Project Identifiers | Project ID: 212914 DEA: 031E0604 EFIS: 0312000068 |
|---|---|
| DIST-CO-RTE-PM | 03-YUB-70-15.5/16.5 |
| Award Date | 07/31/2019 |
| Closeout Date | 08/30/2023 |
| Work Description | SIMMERLY SLOUGH BRIDGE REPLACEMENT BR 16-0019 WITH BR 16-0055. |
| Location Description | NEAR MARYSVILLE, FROM 0.1 MILE NORTH OF BINNEY JUNCTION UNDERPASS TO 0.3 MILE NORTH OF LAURELLEN ROAD, AT SIMMERLY SLOUGH BRIDGE BR 16-0019. |
| QA Service Level | 1 (Verified on 08/22/2019) |
Sample Information
| Sample Taken Date | 12/11/2020 | Sample Unique Key | 13 |
|---|---|---|---|
| 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 testing | 12/11/2020 |
| Sample type | Quality Assurance | A brief description of the sample | 1 gallon can |
| The quantity of what the sample constitutes | 1 gallon can | From where was the sample collected | Source |
| First name of sampler or witnessed by | Daniel | Last name of sampler or witnessed by | Tikusis |
| Title of sampler | Telephone number of sampler | 707-330-9227 | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Kwik Bond | Transportation Laboratory (TL) Number | C631501 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Methacrylate | Mfg. Lot Number(s) | 20-40-390489 |
|---|---|---|---|
| Batch number | 2040390489 | Mix number | 2040390489 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2020-12-11-13-1 CONCLP 4-16 (Verified)