Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2019-06-07-6

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 Date08/16/2023
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 Date06/07/2019 Sample Unique Key6
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 testing06/12/2019
Sample typeQuality Control A brief description of the sample#8 T-Head bars
The quantity of what the sample constitutes5 Lots 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 ID
The fabricator/manufacturer/facility nameHRC Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL131-119-19 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingAuthorization Testing
Rebar Heat Number(s)4084918 Head Manufacturer Lot Number(s)E1193600 Heat100797173
Rebar Size8 Headed Bar Model NameHRC 120
Size of HeadFull Size - 9x Head Connection TypeFriction Weld
Head ShapeSquare Rebar ManufacturerCMC Arizona
Head ManufacturerNucor Head FabricatorHRC
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