Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2026-06-25-22
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 1000607 DEA: 081K6904 EFIS: 0819000090 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-74-5.7/11.8 |
| Award Date | 01/09/2025 |
| Closeout Date | Not set |
| Work Description | ROCK EXCAVATION, HMA (TYPE A), RHMA-G, AND CABLE NET DRAPERY SYSTEM. |
| Location Description | RIVERSIDE COUNTY IN AND NEAR LAKE ELSINORE FROM MONTE VISTA STREET TO GRAND AVENUE |
| QA Service Level | 1 (Verified on 01/13/2025) |
Sample Information
| Sample Taken Date | 06/25/2026 | Sample Unique Key | 22 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | No | Date that the sample was received by the laboratory/organization performing the testing | 07/02/2026 |
| Sample type | Quality Assurance | A brief description of the sample | R71 1-3/8” 150 ksi Epoxy Coated All-Thread Bar |
| The quantity of what the sample constitutes | 4 | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Alexis | Last name of sampler or witnessed by | Millan |
| Title of sampler | CT METS QA INSPECTOR | Telephone number of sampler | 9097569960 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Williams Form Eng | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L191-098-26 | Structure unique identifier | |
| Structure name | Bid Item | 75 - EARTH ANCHOR (SUBHORIZONTAL) |
Material Information
| Material Type | SMTL TM5 - Threaded Bar | Production or Authorization Testing | Authorization Testing |
|---|---|---|---|
| Threaded Bar Specification | ASTM A722 | Threaded Bar Grade | 150 |
| Threaded Bar Type | Plain | Rebar Size | |
| Nut Specification for Threaded Bar | ASTM A29 | System Manufacturer | Williams Form Eng |
| Epoxy Coating Color | Purple | Threaded Bar Application | Soil Nail |
| Coating Standards | ASTM A934 epoxy | Bar Heat Number(s) | 1000228730 |
| Nut Heat Number(s) | 79013697 | Bar Lot Number | |
| Nut Lot Number | Coupler Heat Number(s) | 256637 | |
| Coupler Grade | 1045 |
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. | |||