Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2019-10-02-4

Project Information

Project IdentifiersProject ID: 213357
DEA: 024F2004
EFIS: 0212000071
DIST-CO-RTE-PM02-SHA-44-59.4/59.8
Award Date11/02/2018
Closeout Date01/04/2021
Work DescriptionBRIDGE REPLACEMENT
Location DescriptionSHASTA COUNTY NEAR OLD STATION FROM 0.3 MILE WEST TO 0.2 MILE EAST OF HAT CREEK BRIDGE
QA Service Level1 (Verified on 06/21/2018)

Sample Information

Sample Taken Date10/02/2019 Sample Unique Key4
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 testing10/07/2019
Sample typeAcceptance A brief description of the sample1-3/8" Threaded Bar Grade 150
The quantity of what the sample constitutes2 From where was the sample collectedFabricator
First name of sampler or witnessed byArthur Last name of sampler or witnessed byPeterson
Title of samplerQA Inspector Telephone number of sampler707-342-8602
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameDSI Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL110-139-19 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Threaded Bar Production or Authorization TestingAuthorization Testing
Threaded Bar SpecificationASTM A722 Threaded Bar Grade150
Threaded Bar TypeDeformed Rebar Size11
Nut Specification for Threaded BarASTM A521 System ManufacturerJade Sterling
Epoxy Coating ColorNA Threaded Bar ApplicationThreaded Bar
Coating StandardsUncoated Bar Heat Number(s)6215081003
Nut Heat Number(s)100892437 and F119 Bar Lot NumberNA
Nut Lot NumberNA Coupler Heat Number(s)NA
Coupler GradeNA

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2019-10-02-4-1ASTM A722-15: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)bewingCT HQ - Sacramento Structural Materials Testing Laboratory10/04/2019bewing
Yes
10/04/2019A722 Bar Heat #6215081003, Nut Heat #F119
2019-10-02-4-2ASTM A722-15: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)bewingCT HQ - Sacramento Structural Materials Testing Laboratory10/04/2019bewing
Yes
10/04/2019A722 Bar Heat #6215081003, Nut Heat #100892437