Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2025-11-10-6
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 1001375 DEA: 040A53T4 EFIS: 0421000155 COOP: 040A53TCM |
|---|---|
| DIST-CO-RTE-PM | 04-SOL-80-L1.8/L3.2 |
| Award Date | 06/20/2025 |
| Closeout Date | Not set |
| Work Description | Construct I-80 WB Truck Scales |
| Location Description | CONSTRUCTION ON STATE HIGHWAY IN SOLANO COUNTY IN AND NEAR FAIRFIELD ON ROUTE 12 FROM THE 80/12 EAST JUNCTION TO 0.9 MILE EAST OF CHADBOURNE ROAD UNDERCROSSING AND ON ROUTE 80 FROM 0.5 MILE WEST OF DAN WILSON CREEK BRIDGE TO WEST TEXAS STREET UNDERCROSSI |
| QA Service Level | 1 (Verified on 07/10/2025) |
Sample Information
| Sample Taken Date | 11/10/2025 | Sample Unique Key | 6 |
|---|---|---|---|
| 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 | 11/10/2025 |
| Sample type | Quality Assurance | A brief description of the sample | #11 HRC 120 T-Heads |
| The quantity of what the sample constitutes | 4 Samples from lot 1 | 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 | Osiel Ramirez | Telephone number of sampler | (916) 767-3535 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Headed Reinforcement Corp, Fountain Valley, CA | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L123-075-25 | Structure unique identifier | |
| Structure name | Bid Item | Not set |
Material Information
| Material Type | SMTL TM5 - Headed Bars | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Rebar Heat Number(s) | 9009078 | Head Manufacturer Lot Number(s) | Lot 1 Heat 100023238741 |
| Rebar Size | #11 | Headed Bar Model Name | HRC 120 T Heads |
| Size of Head | Full Size - 9x | Head Connection Type | Friction Weld |
| Head Shape | Square | Rebar Manufacturer | CMC Steel Arizona |
| Head Manufacturer | HRC | Head Fabricator | HRC Fountain Valley |
| Material Standard Code | ASTM A706 | Headed Bar Unique ID | 9FW-17-03 |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Date Added | Verified? | Release Date | Test Comments | Privacy Level | Actions |
|---|---|---|---|---|---|---|---|---|---|
| No results found. | |||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||