Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2018-07-18-17
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 212995 DEA: 01262044 EFIS: 0112000203 |
|---|---|
| DIST-CO-RTE-PM | 01-MEN-101-47.2/47.3 |
| Award Date | 03/29/2018 |
| Closeout Date | 10/05/2020 |
| Work Description | Not set |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 06/26/2019) |
Sample Information
| Sample Taken Date | 07/18/2018 | Sample Unique Key | 17 |
|---|---|---|---|
| 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 | Acceptance | A brief description of the sample | A934 Purple Epoxy Coated Rebar |
| The quantity of what the sample constitutes | 3 heats 1 powder | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Stacey | Last name of sampler or witnessed by | Davis |
| Title of sampler | QAI | Telephone number of sampler | 562 480-6984 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Williams Form Eng | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | B362-058-18 | Structure unique identifier | Not set |
| Structure name | Not set |
Material Information
| Material Type | SMTL TM5 - Threaded Bar | Production or Authorization Testing | Retest |
|---|---|---|---|
| Threaded Bar Specification | ASTM A615 | Threaded Bar Grade | 75 |
| Threaded Bar Type | Deformed | Rebar Size | 9 |
| Nut Specification for Threaded Bar | ASTM A108 | System Manufacturer | Williams Form Engineering |
| Epoxy Coating Color | Purple | Threaded Bar Application | Soil Nail |
| Coating Standards | ASTM A934 epoxy | Bar Heat Number(s) | 100791753, 100891184, 100792512 |
| Nut Heat Number(s) | 8296508 | Bar Lot Number | POG8744 |
| Nut Lot Number | 9J1D | Coupler Heat Number(s) | N/A |
| Coupler Grade | N/A |
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. | |||