Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2020-05-19-8

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 Date05/19/2020 Sample Unique Key8
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 testing05/27/2020
Sample typeQuality Control A brief description of the sample#7 3'-8" Ø Ulitmate Welded Hoops QA Samples Lot 1,2,3
The quantity of what the sample constitutes408 From where was the sample collectedFabricator
First name of sampler or witnessed byRigoberto Last name of sampler or witnessed byMarin
Title of samplerQAI Telephone number of sampler951-500-0685
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameTNT Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL133-092-20 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateUltimate Rebar Heat Number(s)3092809
Hoop Manufacturer Lot Number(s)lot 1,2,3 Material Standard CodeASTM A706
Material Grade60 Rebar Size#7
Diameter of Hoop3'-8" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerCMC Steel CA
Welding CompanyTNT Rebar Coating StandardsUncoated
Weld TypeFlash Welded

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