Sample Record

Owner Lab

  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2021-06-18-29

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 215523
DEA: 120S2004
EFIS: 1219000105
DIST-CO-RTE-PM12-ORA-22,57-R2.7/R11.9,18.8
Award Date04/12/2021
Closeout DateNot set
Work DescriptionPLACE POLYESTER CONCRETE, REPLACE JOINT SEALS AND TREAT BRIDGE DECK.
Location DescriptionORANGE COUNTY AT VARIOUS LOCATIONS ON ROUTE 22 FROM GARDEN GROVE BOULEVARD UNDERCROSSING TO GLASSELL STREET UNDERCROSSING AND ON ROUTE 57 AT BASTANCHURY ROAD UNDERCROSSING
QA Service Level1 (Verified on 05/20/2021)

Sample Information

Sample Taken Date06/18/2021 Sample Unique Key29
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 testing06/21/2021
Sample typeQuality Control A brief description of the sample2 pints 204, chp, z cure, 8020
The quantity of what the sample constitutes25000 gallons From where was the sample collectedSource
First name of sampler or witnessed byDaniel Last name of sampler or witnessed byTikusis
Title of sampler Telephone number of sampler17073309227
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameKwik Bond Polymers, Benicia Transportation Laboratory (TL) NumberC943077
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeMethacrylate Mfg. Lot Number(s)2170790889
Batch number2170790889 Mix number3524

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-06-18-29-1CONCLP 4-16: HMWMSpencer AdamsCT HQ - Sacramento Concrete Testing Laboratory07/15/2021Spencer Adams
Yes
07/30/2021Bond Strength and Tack Free Accepted Based On Supplier Results.