Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2021-11-04-3
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214639 DEA: 040A7704 EFIS: 0400020155 |
|---|---|
| DIST-CO-RTE-PM | 04-ALA-80-6.4/6.7 |
| Award Date | Not set |
| Closeout Date | 03/18/2025 |
| Work Description | Modify Gilman St IC in Berkeley |
| Location Description | Both sides of I-80/Gilman St intersections |
| QA Service Level | 1 (Verified on 01/24/2020) |
Sample Information
| Sample Taken Date | 11/04/2021 | Sample Unique Key | 3 |
|---|---|---|---|
| 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 Control | A brief description of the sample | #5 HRC 120 T Head |
| The quantity of what the sample constitutes | 11 (Lot 1) | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Brian | Last name of sampler or witnessed by | Murray |
| Title of sampler | QA Inspector | Telephone number of sampler | 213 435 4055 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | HRC Fountain Valley | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L140-244-21 | Structure unique identifier | |
| Structure name | Bid Item | Not set |
Material Information
| Material Type | SMTL TM5 - Headed Bars | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Rebar Heat Number(s) | 41111735 | Head Manufacturer Lot Number(s) | 10021114224 |
| Rebar Size | #5 | Headed Bar Model Name | HRC 120 |
| Size of Head | Full Size - 9x | Head Connection Type | Friction Weld |
| Head Shape | Square | Rebar Manufacturer | CMC Rebar |
| Head Manufacturer | Nucor | Head Fabricator | Nucor |
| Material Standard Code | ASTM A706 | Headed Bar Unique ID | Not set |
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. | |||