Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2019-07-19-3

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 Date07/14/2022
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 Date07/19/2019 Sample Unique Key3
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#9 Headed rebar
The quantity of what the sample constitutes43 From where was the sample collectedManufacturer
First name of sampler or witnessed bySteve Last name of sampler or witnessed byHall
Title of samplerQA Inspector Telephone number of sampler646 632 7821
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHeaded Reinforcement Corp, Fountain Valley, CA Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)9000731 Head Manufacturer Lot Number(s)113
Rebar Size9 Headed Bar Model NameHRC 120
Size of HeadFull Size - 9x Head Connection TypeFriction Weld
Head ShapeSquare Rebar ManufacturerCMC Steel
Head ManufacturerHRC Head FabricatorHRC Fountain Valley
Material Standard CodeASTM A615 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