Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2019-04-12-3

Project Information

Project IdentifiersProject ID: 211260
DEA: 072159U4
EFIS: 0715000160
DIST-CO-RTE-PM07-LA,ORA-5-0.0/1.5, 44.3/44.4
Award Date05/27/2016
Closeout Date08/01/2023
Work DescriptionCONSTRUCT HOV LANES AND MIX FLOW LANES.
Location DescriptionLOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
QA Service Level1 (Verified on 03/16/2016)

Sample Information

Sample Taken Date04/12/2019 Sample Unique Key3
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 testing04/12/2019
Sample typeQuality Control A brief description of the sampleA-706 T-Headed Rebar
The quantity of what the sample constitutes4 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 nameIntegrity Rebar Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL115-046-19 Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)65032923 Head Manufacturer Lot Number(s)A177060
Rebar Size9 Headed Bar Model NameBarsplice Buttonhead
Size of HeadFull Size - 9x Head Connection TypeCrimped Head
Head ShapeCircular Rebar ManufacturerCMC Rebar
Head ManufacturerBarsplice Head FabricatorIntegrity Rebar
Material Standard CodeASTM A706 Headed Bar Unique IDNot set

Submitted Tests

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

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Test File Attachments