Sample Record
Owner Labs
- CT HQ - QASI Los Angeles Field Office
- CT HQ - Sacramento Structural Materials Testing Laboratory
DIME Sample ID 2025-06-17-2
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Project Information
| Project Identifiers | Project ID: 1000665 DEA: 081K4004 EFIS: 0819000031 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-15-3.5/6.8 |
| Award Date | 01/29/2025 |
| Closeout Date | Not set |
| Work Description | HMA (TYPE A), RDWY EXC, STR CONC RET WALL, RUBBERIZED HMA (OGFC). |
| Location Description | TEMECULA FROM 0.1 MI NORTH OF TEMECULA PARKWAY TO 0.2 MI NORTH OF WINCHESTER ROAD |
| QA Service Level | 1 (Verified on 01/13/2025) |
Sample Information
| Sample Taken Date | 06/17/2025 | Sample Unique Key | 2 |
|---|---|---|---|
| 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 | 06/26/2025 |
| Sample type | Quality Assurance | A brief description of the sample | #9 gr75 all Threaded bars |
| The quantity of what the sample constitutes | 4 Samples from 63 pcs | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Osiel | Last name of sampler or witnessed by | Ramirez |
| Title of sampler | Quality Assurance Inspector | Telephone number of sampler | (916) 767-3535 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Williams Form Engineering-SD | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L123-051-25 | Structure unique identifier | |
| Structure name | Bid Item | Not set |
Material Information
| Material Type | SMTL TM5 - Threaded Bar | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Threaded Bar Specification | ASTM A615 | Threaded Bar Grade | 75 |
| Threaded Bar Type | Deformed | Rebar Size | #9 |
| Nut Specification for Threaded Bar | ASTM A29/A108 | System Manufacturer | William Form Enginering |
| Epoxy Coating Color | Purple | Threaded Bar Application | Soil Nail |
| Coating Standards | ASTM A934 epoxy | Bar Heat Number(s) | 1000124347 |
| Nut Heat Number(s) | 5395713 | Bar Lot Number | Lot 1 (63 ea.) |
| Nut Lot Number | Lots 1-2 (292 ea.) | Coupler Heat Number(s) | N.A |
| Coupler Grade | N.A |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2025-06-17-2-1 ASTM A615-20 (Verified)