Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2019-08-07-3

Project Information

Project IdentifiersProject ID: 212501
DEA: 022E4804
EFIS: 0200000586
DIST-CO-RTE-PM02-SIS-96,263-103.1/103.6,56.8/57.2
Award Date12/14/2018
Closeout Date12/01/2021
Work DescriptionBRIDGE REPLACEMENT
Location DescriptionSISKIYOU COUNTY ABOUT 8 MILES NORTH OF YREKA ON ROUTE 96 FROM 0.5 MILE WEST TO 0.2 MILE EAST OF ROUTE 263 AND ON ROUTE 263 FROM 0.3 MILE NORTH OF SHASTA RIVER BRIDGE #02-0014 TO ROUTE 96
QA Service Level1 (Verified on 06/06/2017)

Sample Information

Sample Taken Date08/07/2019 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 testing08/07/2019
Sample typeQuality Control A brief description of the sample#6 A706 2'-5" diameter Hoops
The quantity of what the sample constitutesLot 1A and 6A 300 Total From where was the sample collectedFabricator
First name of sampler or witnessed byDavid Last name of sampler or witnessed byWeeks
Title of samplerASI Telephone number of sampler310-883-8369
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameTNT Rebar Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL79-168-19 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateUltimate Rebar Heat Number(s)1201014208
Hoop Manufacturer Lot Number(s)Lot 1A and Lot 6A Material Standard CodeASTM A706
Material Grade60 Rebar Size6
Diameter of Hoop2'-5" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerNucor
Welding CompanyTNT Rebar 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