Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2021-02-03-5
Project Information
| Project Identifiers | Project ID: 213653 DEA: 044G8204 EFIS: 0413000049 |
|---|---|
| DIST-CO-RTE-PM | 04-MRN-101-10.6/10.8 |
| Award Date | 05/05/2020 |
| Closeout Date | 08/14/2023 |
| Work Description | REPLACE SAN RAFAEL HARBOR BRIDGE (ABC) |
| Location Description | MARIN COUTY, IN SAN RAFAEL, FROM ROUTE 101 NORTHBOUND OFF-RAMP TO 2ND STREET |
| QA Service Level | 1 (Verified on 05/31/2019) |
Sample Information
| Sample Taken Date | 02/03/2021 | Sample Unique Key | 5 |
|---|---|---|---|
| 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 | Not set |
| Sample type | Quality Control | A brief description of the sample | #6 button headed bar |
| The quantity of what the sample constitutes | 4 Headed Bars from lot 1 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Osiel | Last name of sampler or witnessed by | Ramirez |
| Title of sampler | Quality Assurance Inspector | Telephone number of sampler | 5599740870 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Camblin Steel Service | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L123-023-21 | Structure unique identifier | |
| Structure name | Bid Item | Not set |
Material Information
| Material Type | SMTL TM5 - Headed Bars | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Rebar Heat Number(s) | 6019603 | Head Manufacturer Lot Number(s) | 13G2 |
| Rebar Size | #6 | Headed Bar Model Name | BNX Buttonhead |
| Size of Head | Full Size - 9x | Head Connection Type | Forged |
| Head Shape | Circular | Rebar Manufacturer | CMC Steel California |
| Head Manufacturer | Bar Splice Products | Head Fabricator | Bar Splice |
| Material Standard Code | ASTM A706 | Headed Bar Unique ID | Not set |
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. | |||
