Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2020-07-09-1

Project Information

Project IdentifiersProject ID: 7613
DEA: 071218W4
EFIS: 0700021119
DIST-CO-RTE-PM07-LA-5-29.4/31.6
Award Date11/29/2012
Closeout DateNot set
Work DescriptionREALIGN ROUTE 5 AND RAILROAD TRACKS AND RECONFIGURE ON- AND OFF-RAMPS.
Location DescriptionLOS ANGELES COUNTY IN BURBANK FROM WEST MAGNOLIA BOULEVARD OVERCROSSING TO 0.3 MILE NORTH OF BUENA VISTA STREET/WINONA AVENUE UNDERCROSSING
QA Service Level1 (Verified on 10/08/2012)

Sample Information

Sample Taken Date07/09/2020 Sample Unique Key1
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 typeQuality Assurance A brief description of the sampleHRC 500/510 coupled
The quantity of what the sample constitutes36 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 nameIntegrity Rebar Placers Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL08-065-20 Structure unique identifier19-Los Angeles
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)6503051602 Head Manufacturer Lot Number(s)A190833 / 100799113
Rebar Size#4 Headed Bar Model Name500 and 510
Size of HeadFull Size - 9x Head Connection TypeForged
Head ShapeCircular Rebar ManufacturerGerdau
Head ManufacturerIntegrity Rebar Placers Head FabricatorHRC
Material Standard CodeASTM A706

Submitted Tests

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