Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2022-04-22-6
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215109 DEA: 081C8504 EFIS: 0813000047 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-74-0.0/5.8 |
| Award Date | 11/12/2020 |
| Closeout Date | 06/02/2025 |
| Work Description | ROADWAY EXCAVATION, HOT MIX ASPHALT, AND STRUCTURAL SHOTCRETE WALLS. |
| Location Description | RIVERSIDE COUNTY NEAR LAKE ELSINORE FROM ORANGE COUNTY LINE TO MONTE VISTA STREET |
| QA Service Level | 1 (Verified on 02/24/2021) |
Sample Information
| Sample Taken Date | 04/22/2022 | Sample Unique Key | 6 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | Yes | Date that the sample was received by the laboratory/organization performing the testing | 04/25/2022 |
| Sample type | Quality Assurance | A brief description of the sample | R72 Coupler 1-3/8" |
| The quantity of what the sample constitutes | 2 Couplers from 98 total | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Osiel | Last name of sampler or witnessed by | Ramirez |
| Title of sampler | Telephone number of sampler | 5599740870 | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Williams Form Engineering-SD | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L123-031-22 | Structure unique identifier | |
| Structure name | Bid Item | Not set |
Material Information
| Material Type | SMTL TM5 - Couplers | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Service or Ultimate | Ultimate | Material Standard Code | ASTM A706 |
| Material Grade | 60 | Rebar Manufacturer | To be provided |
| Coupler Manufacturer | Williams Form Engineering | Intermediate Assembler or Fabricator | |
| Rebar Size | #10 | Coupler Model | R72 Stop Type Coupling |
| Coating Standards | ASTM A934 epoxy | Shape of Rebar | Straight |
| 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 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. | |||