Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2021-08-31-1
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 | 08/31/2021 | 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 | 09/07/2021 |
| Sample type | Quality Assurance | A brief description of the sample | #5 Lenton Threaded Bar Couplers |
| The quantity of what the sample constitutes | Lot 1 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Paul | Last name of sampler or witnessed by | Shrestha |
| Title of sampler | QA Inspector | Telephone number of sampler | (424)298-7781 |
| 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 | L108-010-21 | Structure unique identifier | |
| Structure name | Bid Item | Not set |
Material Information
| Material Type | SMTL TM5 - Couplers | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Service or Ultimate | Service | Material Standard Code | ASTM A615 |
| Material Grade | 60 | Rebar Manufacturer | Vinton Steel |
| Coupler Manufacturer | Erico International | Intermediate Assembler or Fabricator | |
| Rebar Size | #5 | Coupler Model | Lenton Form Saver |
| Coating Standards | Uncoated | Shape of Rebar | Straight |
| Rebar Hoop Diameter | Rebar Hoop Fabricator | ||
| Coupler Component Heat/Lot Number(s) | 202040/9830 | Rebar Heat Number(s) | 2121471, 2121499, 2121500 |
| Rebar Size 2 | Coupler Unique ID | Not set |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-08-31-1-1 CTM 670-December 2013 (Verified)
DIME Test ID: 2021-08-31-1-2 CTM 670-December 2013 (Verified)
DIME Test ID: 2021-08-31-1-3 CTM 670-December 2013 (Verified)
