Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2019-12-26-1

Project Information

Project IdentifiersProject ID: 213749
DEA: 120C1104
EFIS: 1200000633
DIST-CO-RTE-PM12-ORA-57-20.3/21.6
Award Date04/19/2019
Closeout DateNot set
Work DescriptionWIDEN BRIDGES AND CONSTRUCT RW, SW, HMA, JPCP AND ELECTRICAL SYSTEMS.
Location DescriptionORANGE COUNTY IN BREA FROM 0.6 MILE SOUTH TO 0.7 MILE NORTH OF LAMBERT ROAD UNDERCROSSING
QA Service Level1 (Verified on 05/31/2019)

Sample Information

Sample Taken Date12/26/2019 Sample Unique Key1
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 testing12/27/2019
Sample typeAuthorization A brief description of the sample#10 grip twist couplers
The quantity of what the sample constitutes8 SAMPLES From where was the sample collectedFabricator
First name of sampler or witnessed byOsiel Last name of sampler or witnessed byRamirez
Title of samplerQA Inspector Telephone number of sampler5599740870
Laboratory sample identification Linked DIME Sample IDn/a
The fabricator/manufacturer/facility nameCamblin Steel Services Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL123-088-19 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingAuthorization Testing
Service or UltimateUltimate Material Standard CodeASTM A706
Material Grade60 Rebar ManufacturerCMC Steel California
Coupler ManufacturerSteel Dynamic Inc Intermediate Assembler or FabricatorCamblin Steel Services Inc
Rebar Size10 Coupler ModelGripTwist
Coating StandardsUncoated Shape of RebarStraight
Rebar Hoop Diameter Rebar Hoop Fabricator
Coupler Component Heat/Lot Number(s)A193035 MALE, A190418 FEMALE Rebar Heat Number(s)9001747
Rebar Size 2 10

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.