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Testing Report for 2021-08-31-28-2

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

DEA: 031G7604
EFIS: 0319000240
Project ID: 215681
QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA,NEV-20,80-VAR
Work Description: Remove, furnish and place polyester concrete overlay
Location Description: 03-Pla,Nev-20, 80-VAR
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Tad Sampson
Structure Rep.: Carl Anderson

Sample Information

DIME Sample ID: 2021-08-31-28
TL Number from the TL Form: Sacramento Caltrans lab
Sample Submitted By Organization: Kwik Bond Polymers
Sample Organization Contact: 760-518-6064
Type of Sample: Quality Control
Type of Material: Polyester
Sample Taken Date: 8/31/2021
Date that the sample was received by the laboratory/organization performing the testing: 8/31/2021
The quantity of what the sample constitutes: 2 Tankers 35 Totes
A brief description of the sample: 1 gallon can
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Kwik Bond Polymers and Polynt

Material Information

Mfg. Lot Number(s): 1354783
Batch number: 1354783
Mix number: 1354783

Test Information

DIME Test ID: 2021-08-31-28-2
Test Method: ASTM D1475-Nov13: Standard Test Method For Density of Liquid Coatings, Inks, and Related Products
Date Tested: 9/30/2021
Verified Date: 9/30/2021
Submitted By Organization: CT HQ - Sacramento Concrete Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: larry.mccrum@dot.ca.gov
Organization Phone: (916) 227-7283
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified :

Submitted Test Results

Density Units: pounds/gallons
Liquid Density (pounds per gallon): 8.9131