Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2022-04-20-13

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 Date04/20/2022 Sample Unique Key13
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 testing04/21/2022
Sample typeQuality Control A brief description of the sample#5 x 2'-0" Hoops
The quantity of what the sample constitutes52 Hoops from lots 12-24 From where was the sample collectedFabricator
First name of sampler or witnessed byOsiel Last name of sampler or witnessed byRamirez
Title of sampler Telephone number of sampler5599740870
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameRKR Steel Welding Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL123-028-22 Structure unique identifier
Structure name Bid ItemNot set

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateUltimate Rebar Heat Number(s)1100028176
Hoop Manufacturer Lot Number(s)Lots 12 thru 24 Material Standard CodeASTM A706
Material Grade60 Rebar Size#5
Diameter of Hoop2'-0" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerNucor
Welding CompanyRKR Steel Welding Coating StandardsUncoated
Weld TypeFlash Welded

Submitted Tests

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