Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2017-11-08-1
Project Information
| Project Identifiers | Project ID: 211573 DEA: 050Q6004 EFIS: 0500020290 |
|---|---|
| DIST-CO-RTE-PM | 05-SCR-17-1.0/1.4 |
| Award Date | 09/30/2016 |
| Closeout Date | 06/04/2019 |
| Work Description | ACACIA ERADICATION AND SLOPE STABILIZATION WITH ROADWAY WORK. |
| Location Description | SANTA CRUZ COUNTY NEAR SANTA CRUZ FROM 0.2 MILE NORTH OF PASATIEMPO OVERCROSSING TO BEULAH PARK UNDERCROSSING |
| QA Service Level | 1 (Verified on 12/14/2016) |
Sample Information
| Sample Taken Date | 11/08/2017 | Sample Unique Key | 1 |
|---|---|---|---|
| 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 | 11/09/2017 |
| Sample type | Verification | A brief description of the sample | A615 Gr.75 HDG threaded bar w/A108 HDG nut |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | David | Last name of sampler or witnessed by | Flygare |
| Title of sampler | CA METS QA Inspector | Telephone number of sampler | 801-669-2984 |
| Laboratory sample identification | Unknown | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | Williams Form Eng | Transportation Laboratory (TL) Number | C719148 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | B76-186 | Structure unique identifier | Not set |
| Structure name | Not set | Bid Item | Not set |
Material Information
| Material Type | SMTL TM5 - Headed Bars | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Rebar Heat Number(s) | NF15102802 | Head Manufacturer Lot Number(s) | none |
| Rebar Size | 6 | Headed Bar Model Name | none |
| Size of Head | Full Size - 9x | Head Connection Type | Threaded |
| Head Shape | Circular | Rebar Manufacturer | Nucor |
| Head Manufacturer | mittal | Head Fabricator | none |
| Material Standard Code | ASTM A615 | Headed Bar Unique ID | Not set |
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. | |||
