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Sample Record for 2020-11-05-2

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

Project Information

Project ID: 214847 DEA: 074W8204 EFIS: 0720000009 QA Service Level: 1
DIST-CO-RTE-PM: 07-VEN-101-17.7
Work Description: REPLACE STRUCTURAL CONCRETE BRIDGE AND PLACE CONCRETE BARRIER.
Location Description: VENTURA COUNTY IN CAMARILLO AT CENTRAL AVENUE OVERCROSSING
Contractor Name: BEADOR CONSTRUCTION COMPANY, INC.
Contractor Address: 26320 LESTER CIRCLE, CORONA, CA 92883
Resident Engineer: Saeid Shakeri Structure Rep.: Hussam Buran

Sample Information

DIME Sample ID: 2020-11-05-2
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: Quality Control
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 11/05/2020
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 422
A brief description of the sample: #5 Quick Wedge couplers
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Rouch Rebar

Material Information

Production or Authorization Testing: Production Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: CMC Steel Arizona
Coupler Manufacturer: Erico nVent
Intermediate Assembler or Fabricator: Rouch Rebar
Rebar Size: #5
Coupler Model: Lenton Quick Wedge
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): A202734
Rebar Heat Number(s): 4099688
Rebar Size 2 : 5

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.