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Sample Record for 2021-12-02-13

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Project Information

Project ID: 212112 DEA: 080C2514 EFIS: 0816000076 COOP: 081645 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-10-0.0/13.2
Work Description: Design-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes
Location Description: LA/SBD County Line to PM 13.2 near I-15
Contractor Name: Lane-Security Paving Joint Venture
Contractor Address: 3450 Centre Lake Drive, 1st Floor, Ontario, CA 91761
Resident Engineer: Jose Corona Structure Rep.: Luis Negrete

Sample Information

DIME Sample ID: 2021-12-02-13
TL Number from the TL Form:
Sample Submitted By Organization: G3 Quality, Incorporated - Cerritos
Sample Organization Contact: (562) 321-9840
Type of Sample: Per Request
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 12/02/2021
Date that the sample was received by the laboratory/organization performing the testing: 12/07/2021
The quantity of what the sample constitutes: 108
A brief description of the sample: #6 Dayton Superior Bar Lock
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: Sultana Bridge OC
The fabricator/manufacturer/facility name: CMC Rebar

Material Information

Production or Authorization Testing: Production Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: CMC Rebar
Coupler Manufacturer: Dayton Superior
Intermediate Assembler or Fabricator:
Rebar Size: #6
Coupler Model: Bar Lock S/CA
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): 4000000953
Rebar Heat Number(s): 4111154
Rebar Size 2 :
Coupler Unique ID:

Test Results