Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2019-10-30-1

Project Information

Project IdentifiersProject ID: 208973
DEA: 120H1004
EFIS: 1200000180
COOP: 120670
DIST-CO-RTE-PM12-ORA-405,73,405,605-9.3/24.3
Award Date11/07/2016
Closeout DateNot set
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 DescriptionOrange 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
QA Service Level1 (Verified on 09/10/2015)

Sample Information

Sample Taken Date10/30/2019 Sample Unique Key1
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing11/04/2019
Sample typeQuality Assurance A brief description of the sampleA934 Purple Epoxy Coated Rebar
The quantity of what the sample constitutes2 From where was the sample collectedSource
First name of sampler or witnessed byHitesh Last name of sampler or witnessed byPatel
Title of samplerQuality Assurance Inspector Telephone number of sampler9168691602
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameFletcher Coating Co Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormL131-250-19 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM7 - Epoxy Coated Rebar Rebar Heat Number(s)4087752
Rebar Epoxy Batch Number(s) Rebar Coating SpecificationASTM A934
Rebar Size (#)8 Rebar Coating ColorPurple
Rebar ManufacturerCMC Arizona Rebar CoaterFletcher Coating Company
Rebar Powder ManufacturerUnknown Release NumberUnknown
Quality Assurance CodeUnknown

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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