Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2023-11-08-12

Project Information

Project IdentifiersProject ID: 993815
DEA: 081C0814
EFIS: 0816000086
DIST-CO-RTE-PM08-RIV-10-R60.7/R74.3
Award Date03/28/2022
Closeout DateNot set
Work DescriptionI-10 PAVEMENT REHABILITATION (SEGMENT 1) PROJECT
Location DescriptionCoachella
QA Service Level1 (Verified on 05/03/2022)

Sample Information

Sample Taken Date11/08/2023 Sample Unique Key12
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 testing11/10/2023
Sample typeQuality Control A brief description of the sample#5 Welded Hoop 3'-6"dia.
The quantity of what the sample constitutes712 From where was the sample collectedFabricator
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 nameCMC Rebar Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL159-266-23 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)4133966
Hoop Manufacturer Lot Number(s)1-5 Material Standard CodeASTM A706
Material Grade60 Rebar Size#5
Diameter of Hoop3'-6" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerCMC Arizona
Welding CompanyCMC Rebar San Bernardino Coating StandardsUncoated
Weld TypeFlash Welded

Submitted Tests

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