Sample Record for 2020-01-29-13
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 9999 DEA: 00000000 EFIS: 0000000000 COOP: 99999333399 MINOR: 333333 Permit Numbers: 555555 0400NRT0000
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: YYZ
Contractor Address: 1234 address, Sacramento, CA 95824
Resident Engineer: RE_first RE_last Structure Rep.: SR_First SR_Last
Sample Information
DIME Sample ID: 2020-01-29-13
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Welded Hoops
Sample Taken Date: 01/29/2020
Date that the sample was received by the laboratory/organization performing the testing: 01/30/2020
The quantity of what the sample constitutes: 1
A brief description of the sample: 5 Flash Welded Hoops
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: RKR Steel Welding
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 12345y
Hoop Manufacturer Lot Number(s): 6789
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: 6
Diameter of Hoop: 4'-6"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: Gerdau
Welding Company: RKR Steel Welding
Coating Standards: Uncoated
Weld Type: Flash Welded
Test Results
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2020-01-29-13-1 | CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile) | 01/31/2020 | Not scheduled | Julien Atallah | CT HQ - QASI Los Angeles Field Office | | |
25746
