Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2017-02-16-3

Project Information

Project IdentifiersProject ID: 210808
DEA: 020E0904
EFIS: 0200000016
DIST-CO-RTE-PM02-SHA-5-R29.3/R31.1,R45.0/R45.8
Award Date02/03/2016
Closeout Date10/21/2020
Work DescriptionREPLACE BRIDGE, REALIGN ROADWAY AND SEISMIC RETROFIT
Location DescriptionIN SHASTA COUNTY ABT 8 MI N OF SHASTA LAKE CTY AND NEAR LAKEHEAD FRM TURNTABLE BAY O/C TO 0.1 MI N OF O'BRIEN SRRA & FRM 0.4 MI S TO 0.3 MI N OF DOG CREEK BRIDGE.
QA Service Level1 (Verified on 09/23/2015)

Sample Information

Sample Taken Date02/16/2017 Sample Unique Key3
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing02/16/2017
Sample typeQuality Control A brief description of the sampleUltimate Butt Splice
The quantity of what the sample constitutes99 From where was the sample collectedFabricator
First name of sampler or witnessed byJames Last name of sampler or witnessed byDoe
Title of samplerCALTRANS METS QA INSPECTOR Telephone number of sampler(510) 918-4918
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameHarris Rebar Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormB358-007-17 Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateUltimate Rebar Heat Number(s)SE16104897
Hoop Manufacturer Lot Number(s)H26 Material Standard CodeASTM A706
Material Grade60 Rebar Size8
Diameter of Hoop6'-8" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerNucor
Welding CompanyHarris Rebar Coating StandardsUncoated
Weld TypeFlash Welded

Submitted Tests

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

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Test File Attachments