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Sample Record for 2020-03-19-6


Project Information

Project ID: 208973 DEA: 120H1004 EFIS: 1200000180 COOP: 120670 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-405,73,405,605-9.3/24.3
Work Description: (Alternative Delivery) San Diego Freeway (I-405) Improvement Project SR-73 to I-605, Design Build Project, Administered by Orange County Transportation Authority, Caltrans METS to perform Source Inspection per RFP.
Location Description: Orange and Los Angeles Counties: 12-ORA-405 PM 9.3/24.2 / 07-LA-405 PM 0.0/1.2 12-ORA-22 PM R0.7/R3.8 / 12-ORA-22 PM R0.5/R0.7 12-ORA-73 PM R27.2/R27.8 / 12-ORA-605 PM 3.5/R1.6 07-LA-605 PM R0.0/R1.2
Contractor Name: OC 405 Partners Contractor Address: 3100 W Lake Center Dr
Resident Engineer: Hank Alonso (reports) Structure Rep.: Zachman (reports), Cal

Sample Information

DIME Sample ID: 2020-03-19-6
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: Verification
Type of Material: SMTL TM5 - Threaded Bar
Sample Taken Date: 03/19/2020
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 2 bars 4 nuts
A brief description of the sample: 1-3/8" Threaded Bar w/ nuts
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

Production or Authorization Testing: Production Testing
Threaded Bar Specification: ASTM A722
Threaded Bar Grade: 150
Threaded Bar Type:
Rebar Size:
Nut Specification for Threaded Bar: N/A
System Manufacturer: DSI
Epoxy Coating Color: NA
Threaded Bar Application: Threaded Bar
Coating Standards: Uncoated
Bar Heat Number(s): 6214955103
Nut Heat Number(s): 71079534
Bar Lot Number: N/A
Nut Lot Number: N/A
Coupler Heat Number(s): N/A
Coupler Grade: N/A