Sample Record

Owner Lab

  • CT HQ - QASI Sacramento Field Office

DIME Sample ID 2018-06-29-2

Project Information

Project IdentifiersProject ID: 212741
DEA: 020E1804
EFIS: 0200000022
DIST-CO-RTE-PM02-PLU-89-29.8/30.2
Award Date12/13/2017
Closeout Date12/17/2021
Work DescriptionBRIDGE REPLACEMENT
Location DescriptionPLUMAS COUNTY NEAR CANYON DAM FROM 0.2 MILE SOUTH TO 0.3 MILE NORTH OF LAKE ALMANOR SPILLWAY
QA Service Level1 (Verified on 12/06/2017)

Sample Information

Sample Taken Date06/29/2018 Sample Unique Key2
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 testingNot set
Sample typeAcceptance A brief description of the sample10 HRC 500/510 couplers
The quantity of what the sample constitutes150 splices From where was the sample collectedFabricator
First name of sampler or witnessed byBrian Last name of sampler or witnessed byHolck
Title of samplerCT METS QA INSPECTOR Telephone number of sampler9166620354
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameConFab Lathrop Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form931426 Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingProduction Testing
Service or UltimateUltimate Material Standard CodeASTM A706
Material Grade60 Rebar ManufacturerCMC
Coupler ManufacturerHRC USA Intermediate Assembler or FabricatorConfab Lathrop
Rebar Size10 Coupler ModelHRC 500 510
Coating StandardsUncoated Shape of RebarStraight
Rebar Hoop Diameter Rebar Hoop Fabricator
Coupler Component Heat/Lot Number(s)Lot 1 Rebar Heat Number(s)4073764
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