Sample Record

Owner Labs

  • CT QASI - Los Angeles Field Laboratory
  • CT HQ - Sacramento Structural Materials Testing Laboratory

DIME Sample ID 2019-12-16-3

Project Information

Project IdentifiersProject ID: 213750
DEA: 120K0224
EFIS: 1214000097
DIST-CO-RTE-PM12-ORA-5-14.5/17.1
Award Date03/05/2019
Closeout DateNot set
Work DescriptionSouth County Improvement Project (Phase 2 - Oso/Alicia) CONST BRIDGES, RW, SW, HMA PVMT, JPCP, DRAINAGE, AND ELECT SYSTEMS.
Location DescriptionORANGE COUNTY IN MISSION VIEJO AND LAGUNA HILLS FROM 0.7 MILE SOUTH OF OSO PARKWAY OVERCROSSING TO 0.3 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING
QA Service Level1 (Verified on 04/15/2019)

Sample Information

Sample Taken Date12/16/2019 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 testing12/20/2019
Sample typeAcceptance A brief description of the sample8 ASTM A615 Grade 75 Bare Threaded Bars
The quantity of what the sample constitutes2 From where was the sample collectedManufacturer
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 nameWilliams Form Engineering Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL110-186-19 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Threaded Bar Production or Authorization TestingAuthorization Testing
Threaded Bar SpecificationASTM A615 Threaded Bar Grade75
Threaded Bar TypeDeformed Rebar Size8
Nut Specification for Threaded BarASTM A108 System ManufacturerWilliams Form Engineering
Epoxy Coating ColorNA Threaded Bar ApplicationSoil Nail
Coating StandardsUncoated Bar Heat Number(s)100202022
Nut Heat Number(s)8299543 Bar Lot Number10020202220
Nut Lot Number Coupler Heat Number(s)NA
Coupler GradeNA

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2019-12-16-3-1ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)Brian EwingCT HQ - Sacramento Structural Materials Testing Laboratory12/30/2019Joshua Gallaway
Yes
12/30/2019