Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2024-09-25-10
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Project Information
| Project Identifiers | Project ID: 994673 DEA: 033F0704 EFIS: 0312000054 |
|---|---|
| DIST-CO-RTE-PM | 03-SAC-51-2.0/3.5 |
| Award Date | 08/17/2023 |
| Closeout Date | Not set |
| Work Description | American River Bridge Rehabilitation |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 05/15/2023) |
Sample Information
| Sample Taken Date | 09/25/2024 | 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 | 10/01/2024 |
| Sample type | Quality Assurance | A brief description of the sample | One (1) 1-3/8" Threaded Bar and one (1) 1-3/8" Threaded Bar Assembly with Coupler |
| The quantity of what the sample constitutes | 32 assemblies | From where was the sample collected | Supplier |
| First name of sampler or witnessed by | Preston | Last name of sampler or witnessed by | Brockett |
| Title of sampler | CT METS QA INSPECTOR | Telephone number of sampler | 5627836180 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Williams Form Engineering San Diego | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L175-147-24 | Structure unique identifier | |
| Structure name | Bid Item | Not set |
Material Information
| Material Type | SMTL TM5 - Threaded Bar | Production or Authorization Testing | Authorization Testing |
|---|---|---|---|
| Threaded Bar Specification | ASTM A722 | Threaded Bar Grade | 150 |
| Threaded Bar Type | Deformed | Rebar Size | |
| Nut Specification for Threaded Bar | ASTM A29 | System Manufacturer | Williams Form Engineering San Diego |
| Epoxy Coating Color | NA | Threaded Bar Application | Threaded Bar |
| Coating Standards | Uncoated | Bar Heat Number(s) | 58052332 |
| Nut Heat Number(s) | 20762050 | Bar Lot Number | 58052332/03 |
| Nut Lot Number | 36G9D | Coupler Heat Number(s) | 5395608 |
| Coupler Grade | ASTM A29 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2024-09-25-10-1 ASTM A722-18 (Verified)
DIME Test ID: 2024-09-25-10-2 ASTM A722-18 (Verified)