Sample Record for 2025-10-15-3
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000081 DEA: 081J5404 EFIS: 0818000069
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-2.4
Work Description: CB, JPCP (RSC), STRUCTURAL CONCRETE AND MODIFYING LIGHTING SYSTEMS.
Location Description: SAN BERNARDINO COUNTY IN ONTARIO AT ROUTE 10/15 SEPARATION
Contractor Name: FLATIRON WEST, INC.
Contractor Address: 12121 Scripps Summit Drive, Suite 400, San Diego, CA 92131
Resident Engineer: Giang-Sinh Tran Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2025-10-15-3
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 10/15/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/15/2025
The quantity of what the sample constitutes: 4 Couplers
A brief description of the sample: #11 Couplers
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Next Century Rebar
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Cascade
Coupler Manufacturer: Dayton Barlock
Intermediate Assembler or Fabricator:
Rebar Size: #11
Coupler Model: Dayton Bar lock couplers
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): 4000003593
Rebar Heat Number(s): 331925
Rebar Size 2 :
Coupler Unique ID: SL-17-06
Test Results
