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Sample Record for 2021-08-31-3

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

Project Information

Project ID: 213099 DEA: 041A6614 EFIS: 0415000291 COOP: 042683A1 QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN-101-8.4
Work Description: CONSTRUCTION ON STATE HIGHWAY IN MARIN COUNTY IN LARKSPUR
Location Description:
Contractor Name: Disney Construction
Contractor Address: 533 airport Blvd, Suite 120, Burlingame, CA 94010
Resident Engineer: Steven Russell Structure Rep.: Long Ly

Sample Information

DIME Sample ID: 2021-08-31-3
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: Quality Control
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 08/31/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/07/2021
The quantity of what the sample constitutes: Lot 1, Lot 2, Lot 3, Lot 4, Lot 5
A brief description of the sample: # Lenton Threaded Bar Coupler
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Camblin Steel Service

Material Information

Production or Authorization Testing: Production Testing
Service or Ultimate: Service
Material Standard Code: ASTM A615
Material Grade: 60
Rebar Manufacturer: Vinton Steel
Coupler Manufacturer: Erico International
Intermediate Assembler or Fabricator:
Rebar Size: #5
Coupler Model: Lenton Form Saver
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): 202040/9830
Rebar Heat Number(s): 2121471, 2121499, 2121500
Rebar Size 2 :

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.