Sample Record
Owner Lab
- CT HQ - QASI Sacramento Field Office
DIME Sample ID 2021-05-21-8
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214579 DEA: 010B0904 EFIS: 0100020444 |
|---|---|
| DIST-CO-RTE-PM | 01-DN-101-8.2/8.7 |
| Award Date | 04/21/2020 |
| Closeout Date | Not set |
| Work Description | Panther Creek & Hunter Creek Bridges |
| Location Description | DEL NORTE COUNTY NEAR KLAMATH AT PANTHER CREEK BRIDGE AND AT HUNTER CREEK BRIDGE |
| QA Service Level | 1 (Verified on 03/02/2020) |
Sample Information
| Sample Taken Date | 05/21/2021 | Sample Unique Key | 8 |
|---|---|---|---|
| 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 | 05/21/2021 |
| Sample type | Quality Control | A brief description of the sample | Superior D101 Form Savers |
| The quantity of what the sample constitutes | 134 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Sherri | Last name of sampler or witnessed by | Brannon |
| Title of sampler | QA Inspector | Telephone number of sampler | 916-826-6371 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | PJs Rebar | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | B22-041-21 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM5 - Couplers | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Service or Ultimate | Ultimate | Material Standard Code | ASTM A706 |
| Material Grade | 60 | Rebar Manufacturer | Nucor |
| Coupler Manufacturer | Superior D101 Form Savers | Intermediate Assembler or Fabricator | PJs Rebar |
| Rebar Size | #9 | Coupler Model | Superior D101 Form Savers |
| Coating Standards | Uncoated | Shape of Rebar | Straight |
| Rebar Hoop Diameter | Rebar Hoop Fabricator | ||
| Coupler Component Heat/Lot Number(s) | x | Rebar Heat Number(s) | 0300012919 |
| Rebar Size 2 | 9 | Coupler Unique ID | Not set |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||