Sample Record

DIME Sample ID 2019-12-26-1

Project Information

Project IdentifiersProject ID: 213749
DEA: 120C1104
EFIS: 1200000633
DIST-CO-RTE-PM12-ORA-57-20.3/21.6
Award Date04/19/2019
Closeout Date05/28/2024
Work DescriptionSR-57 Lambert Interchange Project: WIDEN BRIDGES AND CONSTRUCT RW, SW, HMA, JPCP AND ELECTRICAL SYSTEMS.
Location DescriptionORANGE COUNTY IN BREA FROM 0.6 MILE SOUTH TO 0.7 MILE NORTH OF LAMBERT ROAD UNDERCROSSING
QA Service Level1 (Verified on 05/31/2019)

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

Sample Information

Sample Taken Date12/26/2019 Sample Unique Key1
Date that the sample was received by the laboratory/organization performing the testing12/27/2019 Sample typeAuthorization
A brief description of the sample#10 grip twist couplers The quantity of what the sample constitutes8 SAMPLES
From where was the sample collectedFabricator First name of sampler or witnessed byOsiel
Last name of sampler or witnessed byRamirez Title of samplerQA Inspector
Telephone number of sampler5599740870 Laboratory sample identification
Linked DIME Sample IDn/a The fabricator/manufacturer/facility nameCamblin Steel Services
Transportation Laboratory (TL) Number Inspector Lot Number from the Transportation Laboratory (TL) FormL123-088-19
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingAuthorization Testing
Service or UltimateUltimate Material Standard CodeASTM A706
Material Grade60 Rebar ManufacturerCMC Steel California
Coupler ManufacturerSteel Dynamic Inc Intermediate Assembler or FabricatorCamblin Steel Services Inc
Rebar Size10 Coupler ModelGripTwist
Coating StandardsUncoated Shape of RebarStraight
Rebar Hoop Diameter Rebar Hoop Fabricator
Coupler Component Heat/Lot Number(s)A193035 MALE, A190418 FEMALE Rebar Heat Number(s)9001747
Rebar Size 2 10 Coupler Unique IDNot set

Submitted Tests

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