Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2021-04-29-2

Project Information

Project IdentifiersProject ID: 215063
DEA: 032F5704
EFIS: 0300020615
DIST-CO-RTE-PM03-PLA-80-46.3/63.5
Award Date09/23/2020
Closeout Date08/11/2023
Work DescriptionReplace 4 Bridges (OC) on Highway 80 from Crystal Springs to Cisco Grove (Baxter, Drum Forebay)
Location DescriptionNot set
QA Service Level1 (Verified on 11/16/2020)

Sample Information

Sample Taken Date04/29/2021 Sample Unique Key2
Date that the sample was received by the laboratory/organization performing the testingNot set Sample typeQuality Control
A brief description of the sampleHRC 120 #5 headed rebar with hook The quantity of what the sample constitutes2322
From where was the sample collectedFabricator First name of sampler or witnessed bySteven
Last name of sampler or witnessed byHall Title of samplerCT METS QA INSPECTOR
Telephone number of sampler6466327821 Laboratory sample identification
Linked DIME Sample ID The fabricator/manufacturer/facility nameHeaded Reinforcement Corp, Fountain Valley, CA
Transportation Laboratory (TL) Number Inspector Lot Number from the Transportation Laboratory (TL) FormL134-063-21
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)2120765 Head Manufacturer Lot Number(s)1 thru 16
Rebar Size#5 Headed Bar Model NameHRC 120
Size of HeadFull Size - 9x Head Connection TypeFriction Weld
Head ShapeSquare Rebar ManufacturerVinton Steel
Head ManufacturerHeaded Reinforcement Corp Head FabricatorHeaded Reinforcement Corp
Material Standard CodeASTM A706 Headed Bar Unique IDNot set

Submitted Tests

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