Sample Record

Owner Lab

  • CT QASI - Bay Area Field Laboratory

DIME Sample ID 2018-07-18-17

Project Information

Project IdentifiersProject ID: 212995
DEA: 01262044
EFIS: 0112000203
DIST-CO-RTE-PM01-MEN-101-47.2/47.3
Award Date03/29/2018
Closeout Date10/05/2020
Work DescriptionNot set
Location DescriptionNot set
QA Service Level1 (Verified on 06/26/2019)

Sample Information

Sample Taken Date07/18/2018 Sample Unique Key17
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 sampleA934 Purple Epoxy Coated Rebar
The quantity of what the sample constitutes3 heats 1 powder From where was the sample collectedFabricator
First name of sampler or witnessed byStacey Last name of sampler or witnessed byDavis
Title of samplerQAI Telephone number of sampler562 480-6984
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameWilliams Form Eng Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormB362-058-18 Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeSMTL TM5 - Threaded Bar Production or Authorization TestingRetest
Threaded Bar SpecificationASTM A615 Threaded Bar Grade75
Threaded Bar TypeDeformed Rebar Size9
Nut Specification for Threaded BarASTM A108 System ManufacturerWilliams Form Engineering
Epoxy Coating ColorPurple Threaded Bar ApplicationSoil Nail
Coating StandardsASTM A934 epoxy Bar Heat Number(s)100791753, 100891184, 100792512
Nut Heat Number(s)8296508 Bar Lot NumberPOG8744
Nut Lot Number9J1D Coupler Heat Number(s)N/A
Coupler GradeN/A

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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