Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2022-08-15-4

Project Information

Project IdentifiersProject ID: 993771
DEA: 07325204
EFIS: 0716000082
DIST-CO-RTE-PM07-LA-210-R36.7/R37.1
Award Date02/15/2022
Closeout Date01/29/2024
Work DescriptionSan Gabriel River Bridge - CM/GC Project - Hinge And Diaphragm Repairs
Location DescriptionLos Angeles County - LOS ANGELES COUNTY IN IRWINDALE FROM 0.2 MILE EAST OF 0.7 MILE WEST OF IRWINDALE AVENUE OVECROSSING
QA Service Level1 (Verified on 04/21/2022)

Sample Information

Sample Taken Date08/15/2022 Sample Unique Key4
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 testing08/18/2022
Sample typeQuality Assurance A brief description of the sample#11 HRC555 Headed Ends
The quantity of what the sample constitutes234 From where was the sample collectedFabricator
First name of sampler or witnessed byAdrian Last name of sampler or witnessed bySanchez
Title of samplerAssociate Steel Inspector Telephone number of sampler2137133499
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility namePSG 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 TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)1201041289 Head Manufacturer Lot Number(s)1055-T,1057-T
Rebar Size#11 Headed Bar Model NameHRC 555
Size of HeadFull Size - 9x Head Connection Type
Head ShapeCircular Rebar ManufacturerNucor
Head ManufacturerHRC Head FabricatorHRC 555
Material Standard CodeASTM A706 Headed Bar Unique IDNot set

Submitted Tests

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