Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2019-10-07-10

Project Information

Project IdentifiersProject ID: 213411
DEA: 030H10U4
EFIS: 0317000246
DIST-CO-RTE-PM03-SAC-5-9.7/24.9
Award Date05/01/2019
Closeout DateNot set
Work DescriptionNot set
Location DescriptionConstruction on state highway in Sacramento County in and near Sacramento from 1.1 miles south of Elk Grove Boulevard to American River Viaduct
QA Service Level1 (Verified on 07/19/2019)

Sample Information

Sample Taken Date10/07/2019 Sample Unique Key10
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 testing10/09/2019
Sample typeQuality Control A brief description of the sample#7 X 2'-11" Dia Hoops
The quantity of what the sample constitutesQC Samples Lots 1 Thru 7 (1000 pcs) From where was the sample collectedFabricator
First name of sampler or witnessed byOsiel Last name of sampler or witnessed byRamirez
Title of samplerCT METS QA INSPECTOR Telephone number of sampler5599740870
Laboratory sample identification Linked DIME Sample IDN/a
The fabricator/manufacturer/facility nameRKR Steel Welding Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL123-069-19 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateService Rebar Heat Number(s)1911527
Hoop Manufacturer Lot Number(s)lot 1 thru 7 Material Standard CodeASTM A706
Material Grade60 Rebar Size7
Diameter of Hoop2'-11" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerVinton Steel
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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