Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2019-10-08-8

Project Information

Project IdentifiersProject ID: 212914
DEA: 031E0604
EFIS: 0312000068
DIST-CO-RTE-PM03-YUB-70-15.5/16.5
Award Date07/31/2019
Closeout DateNot set
Work DescriptionSIMMERLY SLOUGH BRIDGE REPLACEMENT BR 16-0019 WITH BR 16-0055.
Location DescriptionNEAR MARYSVILLE, FROM 0.1 MILE NORTH OF BINNEY JUNCTION UNDERPASS TO 0.3 MILE NORTH OF LAURELLEN ROAD, AT SIMMERLY SLOUGH BRIDGE BR 16-0019.
QA Service Level1 (Verified on 08/22/2019)

Sample Information

Sample Taken Date10/08/2019 Sample Unique Key8
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 testing10/10/2019
Sample typeQuality Control A brief description of the sample#8X8'-8" Dia Hoops
The quantity of what the sample constitutes20 samples from lot # 6-10 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 ID2019-09-27-2
The fabricator/manufacturer/facility nameCMC Rebar Etiwanda Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL123-071-19 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateService Rebar Heat Number(s)4087669
Hoop Manufacturer Lot Number(s)LOT 6 thru 10 Material Standard CodeASTM A706
Material Grade60 Rebar Size8
Diameter of Hoop8'-8" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerCMC Steel Arizona
Welding CompanyCMC Rebar Etiwanda Coating StandardsUncoated
Weld TypeFlash Welded

Submitted Tests

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