Sample Record
Owner Lab
- CT HQ - Sacramento Concrete Testing Laboratory
DIME Sample ID 2021-06-18-29
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Project Information
| Project Identifiers | Project ID: 215523 DEA: 120S2004 EFIS: 1219000105 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-22,57-R2.7/R11.9,18.8 |
| Award Date | 04/12/2021 |
| Closeout Date | 09/08/2022 |
| Work Description | PLACE POLYESTER CONCRETE, REPLACE JOINT SEALS AND TREAT BRIDGE DECK. |
| Location Description | ORANGE 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 Level | 1 (Verified on 05/20/2021) |
Sample Information
| Sample Taken Date | 06/18/2021 | Sample Unique Key | 29 |
|---|---|---|---|
| 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 | 06/21/2021 |
| Sample type | Quality Control | A brief description of the sample | 2 pints 204, chp, z cure, 8020 |
| The quantity of what the sample constitutes | 25000 gallons | 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 | 17073309227 | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Kwik Bond Polymers, Benicia | Transportation Laboratory (TL) Number | C943077 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Methacrylate | Mfg. Lot Number(s) | 2170790889 |
|---|---|---|---|
| Batch number | 2170790889 | Mix number | 3524 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-06-18-29-1 CONCLP 4-16 (Verified)