Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2020-03-19-2

Project Information

Project IdentifiersProject ID: 208973
DEA: 120H1004
EFIS: 1200000180
COOP: 120670
DIST-CO-RTE-PM12-ORA-405,73,405,605-9.3/24.3
Award Date11/07/2016
Closeout DateNot set
Work Description(Alternative Delivery) San Diego Freeway (I-405) Improvement Project SR-73 to I-605, Design Build Project, Administered by Orange County Transportation Authority, Caltrans METS to perform Source Inspection per RFP.
Location DescriptionOrange and Los Angeles Counties: 12-ORA-405 PM 9.3/24.2 / 07-LA-405 PM 0.0/1.2 12-ORA-22 PM R0.7/R3.8 / 12-ORA-22 PM R0.5/R0.7 12-ORA-73 PM R27.2/R27.8 / 12-ORA-605 PM 3.5/R1.6 07-LA-605 PM R0.0/R1.2
QA Service Level1 (Verified on 09/10/2015)

Sample Information

Sample Taken Date03/19/2020 Sample Unique Key2
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 typeVerification A brief description of the sample2-1/2" bar
The quantity of what the sample constitutesUnknown From where was the sample collectedDistributor
First name of sampler or witnessed byKenneth Last name of sampler or witnessed byVarela
Title of samplerAssociate Steel Inspector Telephone number of sampler(562) 440-7716
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameWilliams Form Eng Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL08-028-20 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Threaded Bar Production or Authorization TestingProduction Testing
Threaded Bar SpecificationASTM A722 Threaded Bar Grade150
Threaded Bar TypePlain Rebar Size
Nut Specification for Threaded BarNuts provided to facilitate bar testing only System ManufacturerWilliams Form Eng
Epoxy Coating ColorNA Threaded Bar Application
Coating StandardsUncoated Bar Heat Number(s)100897803
Nut Heat Number(s)Nuts provided to facilitate bar testing only Bar Lot Number
Nut Lot NumberNuts provided to facilitate bar testing only Coupler Heat Number(s)N/A
Coupler GradeN/A

Submitted Tests

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