Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2019-03-13-1

Project Information

Project IdentifiersProject ID: 210837
DEA: 080J0804
EFIS: 0800000283
COOP: 081625
DIST-CO-RTE-PM08-RIV-15-34.7/51.6
Award Date04/17/2017
Closeout DateNot set
Work Description(Alternative Delivery) DESIGN-BUILD OF THE INTERSTATE 15 EXPRESS LANES PROJECT
Location DescriptionRiverside County and SBD-15-0.0/1.3
QA Service Level1 (Verified on 05/08/2017)

Sample Information

Sample Taken Date03/13/2019 Sample Unique Key1
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 testing03/13/2019
Sample typeQuality Control A brief description of the sampleUBS Hoops
The quantity of what the sample constitutesLot 1,2,3 400 Total From where was the sample collectedFabricator
First name of sampler or witnessed byDavid Last name of sampler or witnessed byWeeks
Title of samplerQA Telephone number of sampler310-883-8369
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameRKR Steel Welding Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL79-119-18 Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateUltimate Rebar Heat Number(s)PL14203363
Hoop Manufacturer Lot Number(s)1,2,and 3 Material Standard CodeASTM A706
Material Grade60 Rebar Size5
Diameter of Hoop3'-2" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerNucor
Welding CompanyRKR Steel Welding Coating StandardsUncoated
Weld TypeFlash Welded

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Test File Attachments