Sample Record
Owner Labs
- CT HQ - QASI Bay Area Field Office
- CT HQ - Sacramento Structural Materials Testing Laboratory
DIME Sample ID 2018-07-18-19
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Project Information
| Project Identifiers | Project ID: 212618 DEA: 044G0564 EFIS: 0417000154 |
|---|---|
| DIST-CO-RTE-PM | 04-ALA-680-M2.4/M12.4 |
| Award Date | 11/16/2017 |
| Closeout Date | 12/08/2022 |
| Work Description | ROADWAY REHAB, BRIDGE REPLACEMENT, RET. WALLS, TOLL SYSTEMS |
| Location Description | FREMONT AND AT SUNOL FROM MISSION BOULEVARD SEPARATION TO KOOPMAN ROAD UNDERCROSSING |
| QA Service Level | 1 (Verified on 10/16/2017) |
Sample Information
| Sample Taken Date | 07/18/2018 | Sample Unique Key | 19 |
|---|---|---|---|
| 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 testing | 07/20/2018 |
| Sample type | Department Acceptance | A brief description of the sample | A934 Purple Epoxy Coated Rebar |
| The quantity of what the sample constitutes | 4 coating dates | 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 | 5624806984 |
| Laboratory sample identification | Linked DIME Sample ID | 2018-07-18-13 | |
| The fabricator/manufacturer/facility name | Williams Form Eng | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | B362-059-18 | 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 | Not applicable | System Manufacturer | Williams Form Engineering |
| Epoxy Coating Color | Purple | Threaded Bar Application | Soil Nail |
| Coating Standards | ASTM A934 epoxy | Bar Heat Number(s) | 100792512, 100891184 |
| Nut Heat Number(s) | Not applicable | Bar Lot Number | See emailed document |
| Nut Lot Number | Not applicable | Coupler Heat Number(s) | Not applicable |
| Coupler Grade | Not applicable |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2018-07-18-19-1 ASTM A934-13 (Verified)
DIME Test ID: 2018-07-18-19-2 ASTM A934-13 (Verified)
DIME Test ID: 2018-07-18-19-3 ASTM A934-13 (Verified)
DIME Test ID: 2018-07-18-19-4 ASTM A934-13 (Verified)