Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2020-02-06-3

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 DescriptionSR-57 Lambert Interchange Project: WIDEN 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 Date02/06/2020 Sample Unique Key3
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing02/07/2020
Sample typeQuality Assurance A brief description of the sample#10 Grip twist couplers
The quantity of what the sample constitutes4 samples from lot #1 From where was the sample collectedFabricator
First name of sampler or witnessed byOsiel Last name of sampler or witnessed byRamirez
Title of samplerQuality Assurance Inspector Telephone number of sampler5599740870
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCamblin Steel Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL123-029-20 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingProduction Testing
Service or UltimateService Material Standard CodeASTM A706
Material Grade60 Rebar ManufacturerCMC Steel California
Coupler ManufacturerSteel Dynamic Inc Intermediate Assembler or FabricatorPatrick Cromwell
Rebar Size10 Coupler ModelGrip Twist
Coating StandardsUncoated Shape of RebarStraight
Rebar Hoop DiameterUnknown Rebar Hoop FabricatorUnknown
Coupler Component Heat/Lot Number(s)5U1Female Heat A190418 5W1 Male Heat A193035 Rebar Heat Number(s)9001747
Rebar Size 2 10 Coupler Unique IDNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments