Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2019-08-02-3

Project Information

Project IdentifiersProject ID: 211775
DEA: 024E6504
EFIS: 0212000012
DIST-CO-RTE-PM02-SIS-96-R52.5/88.4
Award Date07/10/2017
Closeout Date01/05/2021
Work DescriptionWIDEN BRIDGES,POLYESTER CONC OVERLAY,COLD PLANE AC PVMT,HMA,GUARDRAIL
Location DescriptionSISKIYOU COUNTY NEAR SEIAD VALLEY AT VARIOUS LOCATIONS FROM 0.1 MILE WEST OF THOMPSON CREEK BRIDGE TO 0.2 MILE EAST OF BEAVER CREEK BRIDGE
QA Service Level1 (Verified on 08/23/2017)

Sample Information

Sample Taken Date08/02/2019 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 testing08/02/2019
Sample typeQuality Control A brief description of the sample #6 Flash Welded Hoops
The quantity of what the sample constitutes132 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 identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameRKR Steel Welding Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormL131-169-19 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateUltimate Rebar Heat Number(s)xxxxxxx
Hoop Manufacturer Lot Number(s)1 Material Standard CodeASTM A706
Material Grade60 Rebar Size6
Diameter of Hoop1'-8" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar Manufacturerabcd
Welding CompanyRKR Steel Welding Coating StandardsUncoated
Weld TypeFlash Welded

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