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Sample Record for 2018-10-26-3

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 210837 DEA: 080J0804 EFIS: 0800000283 COOP: 081625 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-15-34.7/51.6
Location Description: Riverside County and SBD-15-0.0/1.3
Contractor Name: Skanska-Ames, Joint Venture
Contractor Address: 1801 California Avenue, Corona, CA 92881
Resident Engineer: Roy Fisher (reports) Structure Rep.: Roy Fisher

Sample Information

DIME Sample ID: 2018-10-26-3
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Los Angeles Field Laboratory
Sample Organization Contact: (858) 285-5797
Type of Sample: Recertification
Type of Material: SMTL TM7 - Epoxy Coated Dowels
Sample Taken Date: 10/26/2018
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: Unknown
A brief description of the sample: Epoxy Coated Dowel
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: JC Supply Manufacturing

Material Information

Dowel Metal Heat Number: Unknown
Dowel Epoxy Batch Number:
Dowel Coating Specification: ASTM A884
Dowel Size: 1.5 in
Dowel Coating Color: Purple
Dowel Manufacturer:
Dowel Coater: JC Supply And Manufacturing
Release Number:
Quality Assurance Code:
Rebar Size (#):

Test Results

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.