DIME - Sample Record for DIME Sample ID 2016-10-05-10

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Sample Record

Owner Lab

CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2016-10-05-10

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Project Information

Project Identifiers	Project ID: 209732 DEA: 072881U4 EFIS: 0714000085
DIST-CO-RTE-PM	07-LA-210-R16.1/R25.8
Award Date	02/06/2015
Closeout Date	02/18/2020
Work Description	CONSTRUCT CONCRETE PAVEMENT, PRECAST CONCRETE PANELS, AND SLABS.
Location Description	LOS ANGELES COUNTY IN LA CANADA FLINTRIDGE, GLENDALE AND PASADENA FROM DUNSMORE AVENUE UNDERCROSSING TO NORTH LOS ROBLES AVENUE OVERCROSSING
QA Service Level	1 (Verified on 11/04/2014)

Sample Information

Sample Taken Date	10/05/2016	Sample Unique Key	10
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	10/05/2016
Sample type	Quality Control	A brief description of the sample	polyester resin
The quantity of what the sample constitutes	80 drums	From where was the sample collected	Source
First name of sampler or witnessed by	Randy	Last name of sampler or witnessed by	Slezak
Title of sampler	Unknown	Telephone number of sampler	Unknown
Laboratory sample identification	Unknown	Linked DIME Sample ID	Unknown
The fabricator/manufacturer/facility name	reichhold azusa	Transportation Laboratory (TL) Number	C594910
Inspector Lot Number from the Transportation Laboratory (TL) Form	Unknown	Structure unique identifier	Not set
Structure name	Not set

Material Information

Material Type	Polyester	Mfg. Lot Number(s)	00001005302
Batch number	00001005302	Mix number

Submitted Tests

DIME Test ID	Test Method	Tester Name, Testing Lab	Date Tested	Submitted By	Verified?	Release Date	Test Comments	Actions
2016-10-05-10-5	CONCLP 3-16: Polyester Resin	Mike Mullins, CT HQ - Sacramento Concrete Testing Laboratory	10/13/2016	Mike Mullins	Yes	10/24/2016	bond beam results from supplier

Sample File Attachments

File Name	Extension	Date Uploaded	Actions
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Test File Attachments

DIME Test ID: 2016-10-05-10-5 CONCLP 3-16 (Verified)