Sample Record

Owner Lab

  • CT - Unassigned/General Field Laboratory

DIME Sample ID 2018-08-06-2

Project Information

Project IdentifiersProject ID: 212618
DEA: 044G0564
EFIS: 0417000154
DIST-CO-RTE-PM04-ALA-680-M2.4/M12.4
Award Date11/16/2017
Closeout DateNot set
Work DescriptionROADWAY REHAB, BRIDGE REPLACEMENT, RET. WALLS, TOLL SYSTEMS
Location DescriptionFREMONT AND AT SUNOL FROM MISSION BOULEVARD SEPARATION TO KOOPMAN ROAD UNDERCROSSING
QA Service Level1 (Verified on 10/16/2017)

Sample Information

Sample Taken Date08/06/2018 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 typeQuality Assurance A brief description of the sampleNo. 9 Grade 75 epoxy coated bars, and hex nuts
The quantity of what the sample constitutes150 From where was the sample collectedManufacturer
First name of sampler or witnessed byEd Last name of sampler or witnessed byFleming
Title of samplerTET Telephone number of sampler707-310-2029
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) FormB10-173-18 Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeSMTL TM5 - Threaded Bar Production or Authorization TestingProduction Testing
Threaded Bar SpecificationASTM A615 Threaded Bar Grade75
Threaded Bar TypeDeformed Rebar Size
Nut Specification for Threaded BarASTM A576 System ManufacturerWilliams Form Eng
Epoxy Coating ColorPurple Threaded Bar ApplicationSoil Nail
Coating StandardsASTM A934 epoxy Bar Heat Number(s)100890429 100791753
Nut Heat Number(s)8296508 Bar Lot Number100890429042921 10079175321
Nut Lot Number9J1D Coupler Heat Number(s)
Coupler Grade

Submitted Tests

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