Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2022-10-31-18

Project Information

Project IdentifiersProject ID: 212112
DEA: 080C2514
EFIS: 0816000076
COOP: 081645
DIST-CO-RTE-PM08-SBD-10-0.0/13.2
Award Date06/06/2018
Closeout DateNot set
Work DescriptionDesign-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes
Location DescriptionLA/SBD County Line to PM 13.2 near I-15
QA Service Level1 (Verified on 10/16/2019)

Sample Information

Sample Taken Date10/31/2022 Sample Unique Key18
Date that the sample was received by the laboratory/organization performing the testing11/03/2022 Sample typeQuality Assurance
A brief description of the sample5/8" dia Thresded rod HDG The quantity of what the sample constitutes42
From where was the sample collectedDistributor First name of sampler or witnessed byAdrian
Last name of sampler or witnessed bySanchez Title of sampler
Telephone number of sampler2137133499 Laboratory sample identification
Linked DIME Sample ID The fabricator/manufacturer/facility nameCraneVeyor Corp
Transportation Laboratory (TL) Number Inspector Lot Number from the Transportation Laboratory (TL) FormL159-118-22
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypeSMTL TM5 - Threaded Bar Production or Authorization TestingProduction Testing
Threaded Bar SpecificationASTM A193 Threaded Bar Grade105
Threaded Bar Type Rebar Size
Nut Specification for Threaded BarASTM A563 System ManufacturerCraneVayer Corp
Epoxy Coating ColorNA Threaded Bar Application
Coating StandardsUncoated Bar Heat Number(s)10761910
Nut Heat Number(s) Bar Lot Number
Nut Lot Number Coupler Heat Number(s)
Coupler Grade

Submitted Tests

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