Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2022-03-24-3

Project Information

Project IdentifiersProject ID: 215456
DEA: 07293604
EFIS: 0713000238
DIST-CO-RTE-PM07-LA-405-14.3/15.8
Award Date05/26/2021
Closeout Date07/03/2025
Work DescriptionCONSTRUCT AUXILIARY LANE AND WIDEN ON AND OFF RAMPS.
Location DescriptionLOS ANGELES COUNTY IN TORRANCE BETWEEN WESTERN AVENUE UNDERCROSSING AND WEST 182ND STREET
QA Service Level1 (Verified on 07/07/2021)

Sample Information

Sample Taken Date03/24/2022 Sample Unique Key3
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 testingNot set
Sample typeVerification A brief description of the sample(QTY 2) 3/8" x 6" x 18" flatbar
The quantity of what the sample constitutesUnknown Quantity From where was the sample collectedFabricator
First name of sampler or witnessed bySteve Last name of sampler or witnessed byHall
Title of samplerCT METS QA INSPECTOR Telephone number of sampler6466327821
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameMobile Pipe Lining Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL134-012-22 Structure unique identifier
Structure name Bid ItemNot set

Material Information

Material TypeSMTL TM6 - Steel Check Sample Plate Heat Number(s)1201033617
Material SpecificationA36 Grade36
Thickness.375" ShapeRectangle
Metal Foundry Manufacturer (Mill)Nucor Plate Dimension6" x 18" (QTY 2)

Submitted Tests

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