Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2019-04-12-3

Project Information

Project IdentifiersProject ID: 211260
DEA: 072159U4
EFIS: 0715000160
DIST-CO-RTE-PM07-LA,ORA-5-0.0/1.5, 44.3/44.4
Award Date05/27/2016
Closeout Date08/01/2023
Work DescriptionCONSTRUCT HOV LANES AND MIX FLOW LANES.
Location DescriptionLOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
QA Service Level1 (Verified on 03/16/2016)

Sample Information

Sample Taken Date04/12/2019 Sample Unique Key3
Date that the sample was received by the laboratory/organization performing the testing04/12/2019 Sample typeQuality Control
A brief description of the sampleA-706 T-Headed Rebar The quantity of what the sample constitutes4
From where was the sample collectedFabricator First name of sampler or witnessed byLorenzo
Last name of sampler or witnessed byGarcia Title of samplerQA
Telephone number of sampler702 917-2503 Laboratory sample identification
Linked DIME Sample ID The fabricator/manufacturer/facility nameIntegrity Rebar
Transportation Laboratory (TL) Number Inspector Lot Number from the Transportation Laboratory (TL) FormL115-046-19
Structure unique identifierNot set Structure nameNot set
Bid ItemNot set

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)65032923 Head Manufacturer Lot Number(s)A177060
Rebar Size9 Headed Bar Model NameBarsplice Buttonhead
Size of HeadFull Size - 9x Head Connection TypeCrimped Head
Head ShapeCircular Rebar ManufacturerCMC Rebar
Head ManufacturerBarsplice Head FabricatorIntegrity Rebar
Material Standard CodeASTM A706 Headed Bar Unique IDNot set

Submitted Tests

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