Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2025-10-23-2

Project Information

Project IdentifiersProject ID: 1000403
DEA: 120K91U4
EFIS: 1222000031
DIST-CO-RTE-PM12-ORA-91-R9.2/R11.4
Award Date01/03/2025
Closeout DateNot set
Work DescriptionCONST BRIDGES, RW, SW, PAVEMENT, DRAINAGE AND ELECTRICAL SYSTEMS.
Location DescriptionORANGE COUNTY IN ANAHEIM FROM 0.9 MILE WEST TO 1.3 MILES EAST OF LAKEVIEW AVENUE OVERCROSSING
QA Service Level1 (Verified on 08/19/2024)

Sample Information

Sample Taken Date10/23/2025 Sample Unique Key2
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 testingNot set
Sample typeQuality Control A brief description of the sample#9/29 mm. HRC 150 T-Heads
The quantity of what the sample constitutes4 From where was the sample collectedFabricator
First name of sampler or witnessed byJerry Last name of sampler or witnessed byThomas
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHeaded Reinforcement Corp, Fountain Valley, CA Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name Bid ItemNot set

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingAuthorization Testing
Rebar Heat Number(s)9008944 Head Manufacturer Lot Number(s)Lot 1
Rebar Size#9 Headed Bar Model NameHRC 150 T Heads
Size of HeadFull Size - 9x Head Connection Type
Head ShapeCircular Rebar ManufacturerCMC Steel Arizona
Head ManufacturerNucor Head FabricatorNucor
Material Standard CodeASTM A706 Headed Bar Unique ID9FW-17-04

Submitted Tests

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