Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2019-11-14-3

Project Information

Project IdentifiersProject ID: 211260
DEA: 072159U4
EFIS: 0715000160
DIST-CO-RTE-PM07-LA,ORA-5-0.0/1.5, 44.3/44.4
Award Date05/27/2016
Closeout DateNot set
Work DescriptionCONSTRUCT HOV LANES AND MIX FLOW LANES.
Location DescriptionLOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
QA Service Level1 (Verified on 03/16/2016)

Sample Information

Sample Taken Date11/14/2019 Sample Unique Key3
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 sampleHeaded Bar
The quantity of what the sample constitutes496 bars total From where was the sample collectedManufacturer
First name of sampler or witnessed byDavid Last name of sampler or witnessed byWeeks
Title of samplerASI Telephone number of sampler310-883-8369
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameIntegrity Rebar Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL79-187-19 Structure unique identifier53-3045
Structure nameValley View

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)65030893 02 Head Manufacturer Lot Number(s)1, 2, 3, and 4
Rebar Size5 Headed Bar Model NameBNX Buttonhead
Size of HeadFull Size - 9x Head Connection TypeFriction Weld
Head ShapeCircular Rebar ManufacturerGerdau
Head ManufacturerBarSplice Head FabricatorBarSplice
Material Standard CodeASTM A706

Submitted Tests

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