Sample Record

DIME Sample ID 2022-04-22-6

Project Information

Project IdentifiersProject ID: 215109
DEA: 081C8504
EFIS: 0813000047
DIST-CO-RTE-PM08-RIV-74-0.0/5.8
Award Date11/12/2020
Closeout Date06/02/2025
Work DescriptionROADWAY EXCAVATION, HOT MIX ASPHALT, AND STRUCTURAL SHOTCRETE WALLS.
Location DescriptionRIVERSIDE COUNTY NEAR LAKE ELSINORE FROM ORANGE COUNTY LINE TO MONTE VISTA STREET
QA Service Level1 (Verified on 02/24/2021)

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

Sample Information

Sample Taken Date04/22/2022 Sample Unique Key6
Date that the sample was received by the laboratory/organization performing the testing04/25/2022 Sample typeQuality Assurance
A brief description of the sampleR72 Coupler 1-3/8" The quantity of what the sample constitutes2 Couplers from 98 total
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 nameWilliams Form Engineering-SD
Transportation Laboratory (TL) Number Inspector Lot Number from the Transportation Laboratory (TL) FormL123-031-22
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingProduction Testing
Service or UltimateUltimate Material Standard CodeASTM A706
Material Grade60 Rebar ManufacturerTo be provided
Coupler ManufacturerWilliams Form Engineering Intermediate Assembler or Fabricator
Rebar Size#10 Coupler ModelR72 Stop Type Coupling
Coating StandardsASTM A934 epoxy Shape of RebarStraight
Rebar Hoop Diameter Rebar Hoop Fabricator
Coupler Component Heat/Lot Number(s)212890 ASTM A29 Rebar Heat Number(s)100100654
Rebar Size 2 Coupler Unique IDNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedDate AddedVerified?Release DateTest CommentsPrivacy LevelActions
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Test File Attachments