Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2019-09-11-5

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 Date09/11/2019 Sample Unique Key5
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#11 Rebar with HRC 120 T Heads
The quantity of what the sample constitutes505 From where was the sample collectedFabricator
First name of sampler or witnessed byChris Last name of sampler or witnessed byDsouza
Title of sampler Telephone number of sampler9492751713
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHRC Fountain Valley 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)770N566 Head Manufacturer Lot Number(s)117 Thru 120
Rebar Size11 Headed Bar Model NameHRC 120 THeads
Size of HeadFull Size - 9x Head Connection Type
Head ShapeSquare Rebar ManufacturerCMC
Head ManufacturerHRC 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