Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212956 DEA: 080R3404 EFIS: 0812000072
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-38-30.9
Work Description: BRIDGE REHABILITATION AND UPGRADE BRIDGE RAILING TO STANDARDS
Location Description: SAN BERNARDINO COUNTY NEAR ANGELUS OAKS AT SANTA ANA RIVER BRIDGERAM
Contractor Name: RSB GROUP, INC.
Contractor Address: 20331 Lake Forest Dr, Lake Forest, CA 92630
Resident Engineer: Ken Tran Structure Rep.: Sylvia Stracner
DIME Sample ID: 2019-04-05-12
TL Number from the TL Form: Vendor submitted
Sample Submitted By Organization: CT HQ - Sacramento Concrete Testing Laboratory
Sample Organization Contact: (916) 594-1991
Type of Sample: Quality Assurance
Type of Material: Methacrylate
Sample Taken Date: 04/05/2019
Date that the sample was received by the laboratory/organization performing the testing: 04/05/2019
The quantity of what the sample constitutes: 1qt.
A brief description of the sample: HMWM
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Supplier
DIME Test ID: 2019-04-05-12-1
Test Method: CONCLP 4-16: HMWM
Verified Date: 04/23/2019
Date Tested: 04/16/2019
Submitted By Organization: CT HQ - Sacramento Concrete Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: spencer.adams@dot.ca.gov
Organization Phone: (916) 227-5716
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Viscosity (ASTM D 2196) Brookfield RVT with UL adapter, 50 RPM @ 77 deg F, 25 max cps @ 77 deg F
|
25 cps
|
Specific gravity (ASTM D 1475) 0.90 min @ 77 deg F
|
1.09
|
Volatile content (ASTM D 2369) 30% max
|
8 %
|
Flash point (ASTM D 3828) more than 180 deg F
|
190 F
|
PCC - SSD bond strength (CA Test 551) 500 psi minimum @ 24 hours
|
829 psi
|
Tack free time, 400 minutes max
|
0 minutes
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