Sample Record

Owner Lab

  • CT METS QASI - Los Angeles Design Build Field Laboratory

DIME Sample ID 2020-09-14-1

Project Information

Project IdentifiersProject ID: 211848
DEA: 112T2174
EFIS: 1116000131
DIST-CO-RTE-PM11-SD-5-R37.4 - R46.5
Award Date12/22/2016
Closeout DateNot set
Work Description(Alternative Delivery) CMGC, San Elijo Highway Bridge Replacement. Replace the San Elijo lagoon highway bridge, construct HOV lanes, construct bike and pedestrian trails and bridge, build multi-use facility at Manchester Ave.
Location DescriptionIN SAN DIEGO COUNTY IN SOLANA BEACH AND ENCINITAS FROM 0.1 MILE NORTH OF LOMAS SANTA FE DRIVE OVERCROSSING TO 0.2 MILE SOUTH OF BIRMINGHAM DRIVE OVERCROSSING
QA Service Level1 (Verified on 01/31/2017)

Sample Information

Sample Taken Date09/14/2020 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 Control A brief description of the sample#18 rebar w-410/490 couplers
The quantity of what the sample constitutes4 Coupler Assemblies From where was the sample collectedFabricator
First name of sampler or witnessed byMichael Last name of sampler or witnessed byKopenski
Title of samplerQA Telephone number of sampler3107459655
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHRC Fountain Valley 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 UltimateService Material Standard CodeASTM A706
Material Grade60 Rebar ManufacturerCMC Steel California
Coupler ManufacturerHRC CMC Rebar Intermediate Assembler or Fabricator
Rebar Size#18 Coupler ModelHRC 410/490
Coating StandardsUncoated Shape of RebarStraight
Rebar Hoop Diameter Rebar Hoop Fabricator
Coupler Component Heat/Lot Number(s)HRC 410 MM19106888 HRC 490 00797905 Rebar Heat Number(s)9002148,1063854,032143
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