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Sample Record for 2021-09-22-2

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

Project Information

Project ID: 215164 DEA: 07317304 EFIS: 0715000237 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-60-0.0/R3.2,11.8/R21.5
Work Description: UPGRADE EXISTING OVERHEAD AND ROADSIDE SIGN PANELS.
Location Description: LOS ANGELS COUNTY FROM 0.4 MILE WEST OF ROUTE 5/60 SEPARATION TO ROUTE 60/710 SEPARATION AND FROM ROUTE 60/605 SEPARATION TO FAIRWAY DRIVE UNDERCROSSING
Contractor Name: PETERSON-CHASE GENERAL ENGINEERING CONSTRUCTION, INC.
Contractor Address: 16351 CONSTRUCTION CIRCLE WEST, IRVINE CA 92606
Resident Engineer: PRAVIN PATEL Structure Rep.: Avtar Bains

Sample Information

DIME Sample ID: 2021-09-22-2
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: 09/22/2021
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: (4) #14Double Row ZAP Screwlok Type 2 Series
A brief description of the sample: Prequalification
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Camblin Steel Service

Material Information

Production or Authorization Testing: Authorization Testing
Service or Ultimate: Ultimate
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: CMC Steel California
Coupler Manufacturer: Double Row ZAP Screwlok Type 2 Series
Intermediate Assembler or Fabricator:
Rebar Size: #14
Coupler Model: SL-17-04
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): MM20106095
Rebar Heat Number(s): 1065673
Rebar Size 2 : 11

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.