Sample Record
Owner Lab
- CT HQ - Sacramento Concrete Testing Laboratory
DIME Sample ID 2021-11-08-56
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Project Information
| Project Identifiers | Project ID: 215589 DEA: 112N0084 EFIS: 1117000153 |
|---|---|
| DIST-CO-RTE-PM | 11-IMP-7,8,78,86,98,111-Var |
| Award Date | 06/25/2021 |
| Closeout Date | 09/14/2023 |
| Work Description | METHACRYLATE BRIDGE DECKS, REPAIR SPALLS AND REPLACE JOINT SEALS. |
| Location Description | IMPERIAL COUNTY AT VARIOUS LOCATIONS. |
| QA Service Level | 1 (Verified on 07/06/2021) |
Sample Information
| Sample Taken Date | 11/08/2021 | Sample Unique Key | 56 |
|---|---|---|---|
| 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 | 11/08/2021 |
| Sample type | Quality Assurance | A brief description of the sample | Rapid Set Patch |
| The quantity of what the sample constitutes | 2 bags | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Zach | Last name of sampler or witnessed by | Gebhardt |
| Title of sampler | Supplier Representative | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Western Material & Design LLC | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Rapid Set | Manufacturer | Western Material and Design LLC |
|---|---|---|---|
| Mix no. | 3580 | Materials Received | FasTrac 246 |
| Lot no. | A1016211T | Batch no. | A1016211T |
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-11-08-56-1 CONCLP 2-16 (Verified)