Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2019-10-02-4
Project Information
| Project Identifiers | Project ID: 213357 DEA: 024F2004 EFIS: 0212000071 |
|---|---|
| DIST-CO-RTE-PM | 02-SHA-44-59.4/59.8 |
| Award Date | 11/02/2018 |
| Closeout Date | 01/04/2021 |
| Work Description | BRIDGE REPLACEMENT |
| Location Description | SHASTA COUNTY NEAR OLD STATION FROM 0.3 MILE WEST TO 0.2 MILE EAST OF HAT CREEK BRIDGE |
| QA Service Level | 1 (Verified on 06/21/2018) |
Sample Information
| Sample Taken Date | 10/02/2019 | Sample Unique Key | 4 |
|---|---|---|---|
| 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 | 10/07/2019 |
| Sample type | Department Acceptance | A brief description of the sample | 1-3/8" Threaded Bar Grade 150 |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Arthur | Last name of sampler or witnessed by | Peterson |
| Title of sampler | QA Inspector | Telephone number of sampler | 707-342-8602 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | DSI | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L110-139-19 | Structure unique identifier | |
| Structure name | Bid Item | Not set |
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 | Deformed | Rebar Size | 11 |
| Nut Specification for Threaded Bar | ASTM A521 | System Manufacturer | Jade Sterling |
| Epoxy Coating Color | NA | Threaded Bar Application | Threaded Bar |
| Coating Standards | Uncoated | Bar Heat Number(s) | 6215081003 |
| Nut Heat Number(s) | 100892437 and F119 | Bar Lot Number | NA |
| Nut Lot Number | NA | Coupler Heat Number(s) | NA |
| Coupler Grade | NA |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2019-10-02-4-1 ASTM A722-15 (Verified)
DIME Test ID: 2019-10-02-4-2 ASTM A722-15 (Verified)
