Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2019-05-21-4

Project Information

Project IdentifiersProject ID: 3825
DEA: 07138204
EFIS: 0700000142
DIST-CO-RTE-PM07-LA-47,103-3.5/4.6,0.0/1.1
Award Date06/30/2011
Closeout DateNot set
Work DescriptionREPLACE STEEL BRIDGE WITH CIP PS CONCRETE BOX GIRDER BRIDGE AND RAMPS.
Location DescriptionLOS ANGELES COUNTY IN LONG BEACH AND LOS ANGELES ON ROUTE 47 FROM OCEAN BOULEVARD TO ROUTE 103 JUNCTION AND ON ROUTE 103 FROM ROUTE 47 JUNCTION TO ANAHEIM STREET OVERHEAD
QA Service Level1 (Verified on 03/29/2012)

Sample Information

Sample Taken Date05/21/2019 Sample Unique Key4
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 Control A brief description of the sample#11 HRC 120 T-Headed bars
The quantity of what the sample constitutes4 of 103 From where was the sample collectedFabricator
First name of sampler or witnessed byHitesh Last name of sampler or witnessed byPatel
Title of samplerQuality Assurance Inspector Telephone number of sampler9168691602
Laboratory sample identification Linked DIME Sample IDN/A
The fabricator/manufacturer/facility nameHRC Transportation Laboratory (TL) NumberSEQUOIA
Inspector Lot Number from the Transportation Laboratory (TL) FormL131-094-19 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)9000428 Head Manufacturer Lot Number(s)64058963/03
Rebar Size11 Headed Bar Model NameHRC 120
Size of HeadReduced Size - 4x Head Connection TypeFriction Weld
Head ShapeSquare Rebar ManufacturerCMC Rancho Cucamonga
Head ManufacturerNiagara Lasalle Corp Head FabricatorHRC Fountain Valley
Material Standard CodeASTM A706

Submitted Tests

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