Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2017-05-05-3
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 210569 DEA: 083555V4 EFIS: 0814000086 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-15-42.5/46.0 |
| Award Date | 11/05/2015 |
| Closeout Date | 01/18/2022 |
| Work Description | WIDEN I-15, RECONSTRUCT 3 IC'S, CONSTRUCT 2 NEW BR AND WIDEN 3 BR. |
| Location Description | SAN BERNARDINO COUNTY IN VICTORVILLE FROM 0.5 MILE NORTH OF MOJAVE DRIVE TO 1.5 MILE NORTH OF STODDARD WELLS ROAD OVERCROSSING |
| QA Service Level | 1 (Verified on 10/15/2015) |
Sample Information
| Sample Taken Date | 05/05/2017 | Sample Unique Key | 3 |
|---|---|---|---|
| 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 testing | Not set |
| Sample type | Department Acceptance | A brief description of the sample | Two No. 9 grade 75 plain thread bar with two No. 9 grade 75 hex nuts |
| The quantity of what the sample constitutes | Unknown | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Ken | Last name of sampler or witnessed by | Varela |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Williams Form | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | Not set | |
| Structure name | Not set |
Material Information
| Material Type | SMTL TM5 - Threaded Bar | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Threaded Bar Specification | ASTM A615 | Threaded Bar Grade | 75 |
| Threaded Bar Type | Rebar Size | ||
| Nut Specification for Threaded Bar | unknown | System Manufacturer | Williams Form |
| Epoxy Coating Color | NA | Threaded Bar Application | |
| Coating Standards | Uncoated | Bar Heat Number(s) | |
| Nut Heat Number(s) | Bar Lot Number | ||
| Nut Lot Number | Coupler Heat Number(s) | ||
| Coupler Grade |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||