Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2019-03-18-2

Project Information

Project IdentifiersProject ID: 213469
DEA: 024C40V4
EFIS: 0218000125
DIST-CO-RTE-PM02-SHA-5-R3.8/R11.7
Award Date11/06/2018
Closeout DateNot set
Work DescriptionWIDEN TO 6 LANES, BRIDGE REPLACEMENT AND WIDENING AND ROADWAY REHAB
Location DescriptionSHASTA COUNTY IN AND NEAR ANDERSON FROM ROUTE 5/273 SEPARATION TO 0.4 MILE SOUTH OF CHURN CREEK ROAD OVERCROSSING
QA Service Level1 (Verified on 12/31/2018)

Sample Information

Sample Taken Date03/18/2019 Sample Unique Key2
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 testing03/18/2019
Sample typeQuality Control A brief description of the sample Resistance Butt Welded Hoops
The quantity of what the sample constitutes16 From where was the sample collectedFabricator
First name of sampler or witnessed byLorenzo Last name of sampler or witnessed byGarcia
Title of samplerQA Telephone number of sampler702 917-2503
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCMC Rebar Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL115-022-19 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)9000204
Hoop Manufacturer Lot Number(s)1-4 Material Standard CodeASTM A706
Material Grade60 Rebar Size8
Diameter of Hoop7'-0" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerCMC Rebar
Welding CompanyCMC Rebar (Etiwanda) Coating StandardsUncoated
Weld TypeFlash Welded

Submitted Tests

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