Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2019-08-07-5

Project Information

Project IdentifiersProject ID: 212743
DEA: 030H26U4
EFIS: 0317000247
DIST-CO-RTE-PM03-PLA-65-R5.0/R6.6
Award Date02/14/2018
Closeout DateNot set
Work DescriptionNORTHBOUND WIDENING AND RAMP IMPROVEMENTS.
Location DescriptionPLACER COUNTY IN AND NEAR ROSEVILLE AND ROCKLIN FROM 0.1 MILE SOUTH OF EAST ROSEVILLE VIADUCT TO 0.5 MILE SOUTH OF PLEASANT GROVE BOULEVARD OVERCROSSING
QA Service Level1 (Verified on 12/18/2017)

Sample Information

Sample Taken Date08/07/2019 Sample Unique Key5
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 testing08/12/2019
Sample typeQuality Control A brief description of the sample#5 T-Head bars
The quantity of what the sample constitutes2 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) FormL131-182-19 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)4088163 Head Manufacturer Lot Number(s)B1128831
Rebar Size5 Headed Bar Model NameHRC 120
Size of HeadReduced Size - 4x Head Connection TypeForged
Head ShapeCircular Rebar ManufacturerCMC Steel Arizona
Head ManufacturerUnknown Head FabricatorHRC
Material Standard CodeASTM A706

Submitted Tests

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