Sample Record
Owner Lab
- CT METS QASI - Los Angeles Design Build Field Laboratory
DIME Sample ID 2022-11-17-58
Project Information
| Project Identifiers | Project ID: 993559 DEA: 120R5104 EFIS: 1218000102 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-5-36.1 |
| Award Date | 05/04/2022 |
| Closeout Date | Not set |
| Work Description | PLACE RHMA-G AND HIGH FRICTION SURFACE TREATMENT. |
| Location Description | ORANGE COUNTY IN ANAHEIM AT KATELLA AVENUE UNDERCROSSING |
| QA Service Level | 1 (Verified on 03/21/2022) |
Sample Information
| Sample Taken Date | 11/17/2022 | Sample Unique Key | 58 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | No | Date that the sample was received by the laboratory/organization performing the testing | 11/29/2022 |
| Sample type | Quality Assurance | A brief description of the sample | Resins and peroxides |
| The quantity of what the sample constitutes | 5 jars (2 large, 3 small) | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Danny, Waleed, Andrew | Last name of sampler or witnessed by | Chung, Saleh, Ferng |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | ACC | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | High Friction Surface Treatment | Mgf. Lot Number(s) | 111722_112122 |
|---|---|---|---|
| Batch Number | 1 | Mix Number | 1 |
| Resin Binder Type | Polyester | Used for Overlay | Yes |
| Used for Inlay | No |
Submitted Tests
| DIME Test ID | Test Method | Tester Name | Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|---|
| No results found. | |||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||