Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2020-06-17-3

Project Information

Project IdentifiersProject ID: 212501
DEA: 022E4804
EFIS: 0200000586
DIST-CO-RTE-PM02-SIS-96,263-103.1/103.6,56.8/57.2
Award Date12/14/2018
Closeout DateNot set
Work DescriptionBRIDGE REPLACEMENT
Location DescriptionSISKIYOU COUNTY ABOUT 8 MILES NORTH OF YREKA ON ROUTE 96 FROM 0.5 MILE WEST TO 0.2 MILE EAST OF ROUTE 263 AND ON ROUTE 263 FROM 0.3 MILE NORTH OF SHASTA RIVER BRIDGE #02-0014 TO ROUTE 96
QA Service Level1 (Verified on 06/06/2017)

Sample Information

Sample Taken Date06/17/2020 Sample Unique Key3
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 testing06/19/2020
Sample typeQuality Control A brief description of the sample#5 rebar hoops 1'-6" dia
The quantity of what the sample constitutes2 lot of 150 plus 1 lot of 76 From where was the sample collectedFabricator
First name of sampler or witnessed bySteve Last name of sampler or witnessed byHall
Title of samplerCT METS QA INSPECTOR Telephone number of sampler6466327821
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameTNT Rebar Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL134-130-20 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateUltimate Rebar Heat Number(s)1202017208
Hoop Manufacturer Lot Number(s)1, 2 and 3 Material Standard CodeASTM A706
Material Grade60 Rebar Size#5
Diameter of Hoop1'-6" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerNucor
Welding CompanyTNT Rebar Coating StandardsUncoated
Weld TypeFlash Welded

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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