Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2020-10-12-4

Project Information

Project IdentifiersProject ID: 213750
DEA: 120K0224
EFIS: 1214000097
DIST-CO-RTE-PM12-ORA-5-14.5/17.1
Award Date03/05/2019
Closeout DateNot set
Work DescriptionSouth County Improvement Project (Phase 2 - Oso/Alicia) CONST BRIDGES, RW, SW, HMA PVMT, JPCP, DRAINAGE, AND ELECT SYSTEMS.
Location DescriptionORANGE COUNTY IN MISSION VIEJO AND LAGUNA HILLS FROM 0.7 MILE SOUTH OF OSO PARKWAY OVERCROSSING TO 0.3 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING
QA Service Level1 (Verified on 04/15/2019)

Sample Information

Sample Taken Date10/12/2020 Sample Unique Key4
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 testing10/16/2020
Sample typeQuality Control A brief description of the sample#7 BNX Button Headed Rebar
The quantity of what the sample constitutes35 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 nameIntegrity Rebar Placers Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL134-242-20 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)1201021906 Head Manufacturer Lot Number(s)01
Rebar Size#7 Headed Bar Model Name07BNX 8G2
Size of HeadFull Size - 9x Head Connection TypeCrimped Head
Head ShapeCircular Rebar ManufacturerNucor Utah
Head ManufacturerBarsplice Head FabricatorIntegrity Rebar Placers
Material Standard CodeASTM A706 Headed Bar 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