Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2018-01-26-1

Project Information

Project IdentifiersProject ID: 212731
DEA: 07318004
EFIS: 0715000280
DIST-CO-RTE-PM07-LA-10-22.3/28.2
Award Date11/16/2017
Closeout Date06/16/2021
Work DescriptionTREAT BRIDGE DECK, CLOSURE POUR AND REPLACE JOINT SEALS.
Location DescriptionLOS ANGELES COUNTY AT VARIOUS LOCATIONS FROM FREMONT AVENUE UNDERCROSSING TO RIO HONDO62
QA Service Level1 (Verified on 03/21/2018)

Sample Information

Sample Taken Date01/26/2018 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 testing01/30/2018
Sample typeProficiency A brief description of the sampleBarsplice Zap Screwlok Coupler
The quantity of what the sample constitutes4 test bars From where was the sample collectedFabricator
First name of sampler or witnessed byKevin Last name of sampler or witnessed byChurchill
Title of samplerQA Inspector Telephone number of sampler510-693-3545
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameDRS Rebar Inc Transportation Laboratory (TL) NumberC952927
Inspector Lot Number from the Transportation Laboratory (TL) FormL02-006-18 Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingAuthorization Testing
Service or UltimateService Material Standard CodeASTM A706
Material Grade60 Rebar ManufacturerGerdau
Coupler ManufacturerBarSplice Intermediate Assembler or FabricatorRuben Sandoval Patrick Cromwell
Rebar Size5 Coupler Model5DBZA
Coating StandardsUncoated Shape of RebarStraight
Rebar Hoop DiameterUnknown Rebar Hoop FabricatorUnknown
Coupler Component Heat/Lot Number(s)7045 Rebar Heat Number(s)65029565-02
Rebar Size 2 Not set Coupler Unique IDNot set

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