Sample Record
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- CT HQ - QASI Los Angeles Field Office
- CT HQ - Sacramento Structural Materials Testing Laboratory
DIME Sample ID 2020-08-16-1
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Project Information
| Project Identifiers | Project ID: 208973 DEA: 120H1004 EFIS: 1200000180 COOP: 120670 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-405,73,405,605-9.3/24.3 |
| Award Date | 11/07/2016 |
| Closeout Date | Not set |
| Work Description | (Alternative Delivery) San Diego Freeway (I-405) Improvement Project SR-73 to I-605, Design Build Project, Administered by Orange County Transportation Authority, Caltrans METS to perform Source Inspection per RFP. |
| Location Description | Orange and Los Angeles Counties: 12-ORA-405 PM 9.3/24.2 / 07-LA-405 PM 0.0/1.2 12-ORA-22 PM R0.7/R3.8 / 12-ORA-22 PM R0.5/R0.7 12-ORA-73 PM R27.2/R27.8 / 12-ORA-605 PM 3.5/R1.6 07-LA-605 PM R0.0/R1.2 |
| QA Service Level | 1 (Verified on 09/10/2015) |
Sample Information
| Sample Taken Date | 08/16/2020 | 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 | 08/20/2020 |
| Sample type | Verification | A brief description of the sample | #7 A615 all-thread rebar w/ thru coupler |
| The quantity of what the sample constitutes | 71 bar and 220 couplers | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Ken | Last name of sampler or witnessed by | Varela |
| Title of sampler | Assoicate Steel Inspector | Telephone number of sampler | (562) 440-7716 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | William Form Engineering | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L08-078-20 | Structure unique identifier | 30-Orange |
| Structure name | unknown |
Material Information
| Material Type | SMTL TM5 - Threaded Bar | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Threaded Bar Specification | ASTM A615 | Threaded Bar Grade | 75 |
| Threaded Bar Type | Deformed | Rebar Size | #7 |
| Nut Specification for Threaded Bar | N/A | System Manufacturer | Williams Form Eng |
| Epoxy Coating Color | Purple | Threaded Bar Application | Threaded Bar |
| Coating Standards | ASTM A934 epoxy | Bar Heat Number(s) | 100896835 |
| Nut Heat Number(s) | N/A | Bar Lot Number | 10089683520 |
| Nut Lot Number | N/A | Coupler Heat Number(s) | 201154 |
| Coupler Grade | 75 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2020-08-16-1-1 ASTM A615-15 (Verified)
DIME Test ID: 2020-08-16-1-2 ASTM A615-15 (Verified)
DIME Test ID: 2020-08-16-1-3 ASTM A934-13 (Verified)