Sample Record

Owner Lab

  • Kwik Bond Polymers

DIME Sample ID 2024-05-20-134

Project Information

Project IdentifiersProject ID: 995156
DEA: 070W3504
EFIS: 0722000005
DIST-CO-RTE-PM07-LA-91-R11.7
Award Date02/06/2024
Closeout DateNot set
Work DescriptionFURNISH AND PLACE POLYESTER CONCRETE OVERLAY.
Location DescriptionLOS ANGELES COUNTY IN LONG BEACH AT ROUTE 91/710 SEPARATION
QA Service Level1 (Verified on 09/25/2023)

Sample Information

Sample Taken Date05/20/2024 Sample Unique Key134
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 testing05/30/2024
Sample typeQuality Control A brief description of the sample1 gallon can / PPC 1121 RESIN
The quantity of what the sample constitutes10 Tankers From where was the sample collectedSource
First name of sampler or witnessed byGILBERTO Last name of sampler or witnessed byGONZALEZ
Title of samplerQuality Control Manager Telephone number of sampler17076245467
Laboratory sample identification000068KBP Linked DIME Sample ID000068KBP
The fabricator/manufacturer/facility nameKwik Bond Polymers, Benicia Transportation Laboratory (TL) NumberSacramento Caltrans lab
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypePolyester Mfg. Lot Number(s)AZ4E00736
Batch numberAZ4E00736 Mix numberAZ4E00736

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments