Sample Record

Owner Lab

  • CT HQ - QASI Sacramento Field Office

DIME Sample ID 2021-11-09-2

Project Information

Project IdentifiersProject ID: 215063
DEA: 032F5704
EFIS: 0300020615
DIST-CO-RTE-PM03-PLA-80-46.3/63.5
Award Date09/23/2020
Closeout Date08/11/2023
Work DescriptionReplace 4 Bridges (OC) on Highway 80 from Crystal Springs to Cisco Grove (Baxter, Drum Forebay)
Location DescriptionNot set
QA Service Level1 (Verified on 11/16/2020)

Sample Information

Sample Taken Date11/09/2021 Sample Unique Key2
Date that the sample was received by the laboratory/organization performing the testingNot set Sample typeQuality Assurance
A brief description of the sample#6 bar epoxy coated The quantity of what the sample constitutes2
From where was the sample collectedFabricator First name of sampler or witnessed byGordon
Last name of sampler or witnessed byLivermore Title of samplerCT METS QA INSPECTOR
Telephone number of sampler916-753-0227 Laboratory sample identification
Linked DIME Sample ID The fabricator/manufacturer/facility nameAmerican Highway - Simplex
Transportation Laboratory (TL) Number Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypeSMTL TM7 - Epoxy Coated Rebar Rebar Heat Number(s)120236445
Rebar Epoxy Batch Number(s)3ch2010021, 3ch2041027 Rebar Coating SpecificationASTM A934
Rebar Size (#)6 Rebar Coating ColorPurple
Rebar ManufacturerNucor Rebar CoaterAmerican Highway
Rebar Powder ManufacturerSherwin Williams Release Number
Quality Assurance Code

Submitted Tests

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