Sample Record
Owner Lab
- CT HQ - Sacramento Structural Materials Testing Laboratory
DIME Sample ID 2018-05-30-1
Project Information
| Project Identifiers | Project ID: 212247 DEA: 010G8004 MINOR: 01A1727 |
|---|---|
| DIST-CO-RTE-PM | 01-MEN-1-78.0/83.5, 77.0/83.5 |
| Award Date | 01/11/2017 |
| Closeout Date | 04/12/2021 |
| Work Description | Major Damage Restoration |
| Location Description | In Mendocino County near West port from 0.3 mile south of Wages Creek Bridge #10-137 to Solider Point Viaduct #10-271 |
| QA Service Level | 1 (Verified on 03/21/2017) |
Sample Information
| Sample Taken Date | 05/30/2018 | Sample Unique Key | 1 |
|---|---|---|---|
| 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 | 06/04/2018 |
| Sample type | Quality Assurance | A brief description of the sample | 1 3/8 threadbar / nut |
| The quantity of what the sample constitutes | 1 lot | From where was the sample collected | Source |
| First name of sampler or witnessed by | Greg | Last name of sampler or witnessed by | Johnston |
| Title of sampler | QA | Telephone number of sampler | 9165247768 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | DSI | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L53-036-18 | Structure unique identifier | Not set |
| Structure name | Not set |
Material Information
| Material Type | SMTL TM5 - Threaded Bar | Production or Authorization Testing | Authorization Testing |
|---|---|---|---|
| Threaded Bar Specification | ASTM A722 | Threaded Bar Grade | 150 |
| Threaded Bar Type | Rebar Size | ||
| Nut Specification for Threaded Bar | 1035 | System Manufacturer | DSI |
| Epoxy Coating Color | NA | Threaded Bar Application | Threaded Bar |
| Coating Standards | Uncoated | Bar Heat Number(s) | 6214344804 |
| Nut Heat Number(s) | 62142381 | Bar Lot Number | |
| Nut Lot Number | Coupler Heat Number(s) | ||
| Coupler Grade |