Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2025-11-25-5

Project Information

Project IdentifiersProject ID: 1000081
DEA: 081J5404
EFIS: 0818000069
DIST-CO-RTE-PM08-SBD-15-2.4
Award Date04/02/2025
Closeout DateNot set
Work DescriptionCB, JPCP (RSC), STRUCTURAL CONCRETE AND MODIFYING LIGHTING SYSTEMS.
Location DescriptionSAN BERNARDINO COUNTY IN ONTARIO AT ROUTE 10/15 SEPARATION
QA Service Level1 (Verified on 02/06/2024)

Sample Information

Sample Taken Date11/25/2025 Sample Unique Key5
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 testing12/02/2025
Sample typeQuality Assurance A brief description of the sample#6 x 30" rebar, loose tie bars
The quantity of what the sample constitutes320 each From where was the sample collectedManufacturer
First name of sampler or witnessed byAlexis Last name of sampler or witnessed byMillan
Title of samplerCT METS QA INSPECTOR Telephone number of sampler9097569960
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility namePacific Highway Products Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL191-040-25 Structure unique identifier
Structure name Bid Item46 - JOINTED PLAIN CONCRETE PAVEMENT

Material Information

Material TypeSMTL TM7 - Epoxy Coated Rebar Rebar Heat Number(s)4400037431
Rebar Epoxy Batch Number(s)CH0665YM Rebar Coating SpecificationASTM A775
Rebar Size (#)6 Rebar Coating ColorGreen
Rebar ManufacturerNucor Rebar CoaterSimcote
Rebar Powder Manufacturer Release Number
Quality Assurance Code

Submitted Tests

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