Sample Record

Owner Lab

  • CT HQ - Sacramento Structural Materials Testing Laboratory

DIME Sample ID 2020-04-23-3

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 Date04/23/2020 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 testing04/29/2020
Sample typeQuality Assurance A brief description of the sampleBurn Samples
The quantity of what the sample constitutes15 From where was the sample collectedJob Site
First name of sampler or witnessed byNick Last name of sampler or witnessed byHoffmann
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCMC Gerdau Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingProduction Testing
Service or UltimateUltimate Material Standard CodeASTM A706
Material Grade60 Rebar ManufacturerCMC Gerdau
Coupler ManufacturerNA Intermediate Assembler or FabricatorUnknown
Rebar Size#11 Coupler ModelNA
Coating StandardsUncoated Shape of RebarStraight
Rebar Hoop DiameterUnknown Rebar Hoop FabricatorUnknown
Coupler Component Heat/Lot Number(s)NA Rebar Heat Number(s)4093051, 4081726, 6503159702
Rebar Size 2 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