Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2018-11-14-1

Project Information

Project IdentifiersProject ID: 212036
DEA: 044K2404
EFIS: 0417000284
DIST-CO-RTE-PM04-MRN,MRN-1-10.9, 10.8/10.9, 10.90, 6.6/10.9
Award Date01/31/2017
Closeout Date10/17/2022
Work DescriptionConstruct Solier Pile Wall
Location DescriptionNot set
QA Service Level1 (Verified on 03/17/2017)

Sample Information

Sample Taken Date11/14/2018 Sample Unique Key1
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 sampleGalv hoolow bars, hex nuts and couplers
The quantity of what the sample constitutes300 From where was the sample collectedDistributor
First name of sampler or witnessed byKen Last name of sampler or witnessed byVarela
Title of samplerAssociate Steel Inspector Telephone number of sampler(562) 440-7716
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) FormL08-074-18 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 Type Rebar Size
Nut Specification for Threaded BarASTM A29 System Manufacturerunknown
Epoxy Coating ColorNA Threaded Bar Application
Coating StandardsASTM A153 galvanized Bar Heat Number(s)4120583 and 4121251
Nut Heat Number(s)8296322 Bar Lot Number
Nut Lot Number38-85D Coupler Heat Number(s)100889235
Coupler GradeA615 Gr 75

Submitted Tests

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

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Test File Attachments