Sample Record
Owner Lab
- CT HQ - QASI Sacramento Field Office
DIME Sample ID 2024-11-19-5
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 77777 DEA: CHEM-STOCK EFIS: CHEM-STOCK |
|---|---|
| DIST-CO-RTE-PM | 59--- |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | Special project for Chem Lab stock material. Object Code: 1025. J2 DEA: 912680. |
| Location Description | Not set |
| QA Service Level | NOT VERIFIED |
Sample Information
| Sample Taken Date | 11/19/2024 | Sample Unique Key | 5 |
|---|---|---|---|
| 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 | 11/20/2024 |
| Sample type | Verification | A brief description of the sample | 1.5" ASTM A775 Epoxy Coated Dowels |
| The quantity of what the sample constitutes | AD Audit | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Shabnam | Last name of sampler or witnessed by | Riahi |
| Title of sampler | AMR | Telephone number of sampler | 9169529140 |
| Laboratory sample identification | Linked DIME Sample ID | 2024-11-19-5 | |
| The fabricator/manufacturer/facility name | American Highway - Simplex | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | S92-001-24 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM7 - Epoxy Coated Dowels | Dowel Metal Heat Number | 1202063730 |
|---|---|---|---|
| Dowel Epoxy Batch Number | Dowel Coating Specification | ASTM A775 | |
| Dowel Size | 1.5 in | Dowel Coating Color | Green |
| Dowel Manufacturer | Dowel Coater | American Highway Simplex | |
| Release Number | Quality Assurance Code | ||
| Rebar Size (#) |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||