Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2024-04-17-3
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 995498 DEA: 072XL104 EFIS: 0724000158 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-10-14.23 |
| Award Date | 11/11/2023 |
| Closeout Date | 11/04/2025 |
| Work Description | LA-10, Construct temporary structural shoring - Column Casings Repair Work |
| Location Description | I-10 at Olympic Blvd |
| QA Service Level | 1 (Verified on 11/20/2023) |
Sample Information
| Sample Taken Date | 04/17/2024 | Sample Unique Key | 3 |
|---|---|---|---|
| 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 testing | Not set |
| Sample type | Quality Control | A brief description of the sample | #4 Double Barrel Zap Screwlock Couplers |
| The quantity of what the sample constitutes | 1220 couplers/ 7 lots | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Preston | Last name of sampler or witnessed by | Brockett |
| Title of sampler | Quality Assurance Inspector | Telephone number of sampler | 5627836180 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Security Paving Company | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L175-029-24 | 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 | Service | Material Standard Code | ASTM A706 |
| Material Grade | 60 | Rebar Manufacturer | CMC |
| Coupler Manufacturer | BarSplice | Intermediate Assembler or Fabricator | |
| Rebar Size | #4 | Coupler Model | Double Barrel Zap Screwlok |
| Coating Standards | Uncoated | Shape of Rebar | Hoop |
| Rebar Hoop Diameter | Rebar Hoop Fabricator | ||
| Coupler Component Heat/Lot Number(s) | 04DBZA | Rebar Heat Number(s) | 4138494 |
| Rebar Size 2 | Coupler Unique ID | SB-17-02 |
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 |
|---|---|---|---|
| 07-2XL104_6034_L175_04-17-2024_2204_DOC | 04/18/2024 | Info |