Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2021-07-12-1
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 213099 DEA: 041A6614 EFIS: 0415000291 COOP: 042683A1 |
|---|---|
| DIST-CO-RTE-PM | 04-MRN-101-8.4 |
| Award Date | 11/30/2020 |
| Closeout Date | 12/12/2023 |
| Work Description | CONSTRUCTION ON STATE HIGHWAY IN MARIN COUNTY IN LARKSPUR |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 11/06/2020) |
Sample Information
| Sample Taken Date | 07/12/2021 | Sample Unique Key | 1 |
|---|---|---|---|
| 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 Assurance | A brief description of the sample | HS Threaded Bar |
| The quantity of what the sample constitutes | Heat 62150104 | 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 San Diego | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L79-033-21 | Structure unique identifier | 27-0008Z |
| Structure name | Bid Item | Not set |
Material Information
| Material Type | SMTL TM5 - Threaded Bar | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Threaded Bar Specification | ASTM A722 | Threaded Bar Grade | 02 |
| Threaded Bar Type | Plain | Rebar Size | #8 |
| Nut Specification for Threaded Bar | A108 | System Manufacturer | Williams Form Engineering |
| Epoxy Coating Color | NA | Threaded Bar Application | Threaded Bar |
| Coating Standards | Uncoated | Bar Heat Number(s) | 62150104 |
| Nut Heat Number(s) | 8298147 | Bar Lot Number | NA |
| Nut Lot Number | 26E3D | Coupler Heat Number(s) | NA |
| Coupler Grade | NA |
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. | |||