Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2021-07-09-2
Sample is locked from editing. info
Project Information
| Project Identifiers | Project ID: 215188 DEA: 080F5434 EFIS: 0817000239 Permit Numbers: 0823NMC0369 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-I-15,SR-91-6.1-7.6 |
| Award Date | 03/11/2020 |
| Closeout Date | 06/05/2024 |
| Work Description | I-15 ELC: 15/91 Express Lanes Connector Project (ELC) |
| Location Description | Junction of I-15 and SR-91 in Corona, CA |
| QA Service Level | 1 (Verified on 09/16/2020) |
Sample Information
| Sample Taken Date | 07/09/2021 | Sample Unique Key | 2 |
|---|---|---|---|
| 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 | 07/16/2021 |
| Sample type | Quality Assurance | A brief description of the sample | A615 Grade 75 Threaded Bar |
| The quantity of what the sample constitutes | Heat 100108100 | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | David | Last name of sampler or witnessed by | Weeks |
| Title of sampler | ASI | Telephone number of sampler | 310-883-8369 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Williams Form Engineering Golden, CO | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L79-032-21 | Structure unique identifier | |
| Structure name | RW No 5 | Bid Item | Not set |
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 | #9 |
| Nut Specification for Threaded Bar | ASTM A108 | System Manufacturer | Williams Form Engineering |
| Epoxy Coating Color | NA | Threaded Bar Application | Soil Nail |
| Coating Standards | Uncoated | Bar Heat Number(s) | 100108100 |
| Nut Heat Number(s) | 8391467 | Bar Lot Number | NA |
| Nut Lot Number | 9L3D | Coupler Heat Number(s) | NA |
| Coupler Grade | NA |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-07-09-2-1 ASTM A615-15 (Verified)
DIME Test ID: 2021-07-09-2-2 ASTM A615-15 (Verified)
DIME Test ID: 2021-07-09-2-3 ASTM A615-15 (Verified)
