Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2020-10-21-1
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 213750 DEA: 120K0224 EFIS: 1214000097 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-5-14.5/17.1 |
| Award Date | 03/05/2019 |
| Closeout Date | Not set |
| Work Description | South County Improvement Project (Phase 2 - Oso/Alicia) CONST BRIDGES, RW, SW, HMA PVMT, JPCP, DRAINAGE, AND ELECT SYSTEMS. |
| Location Description | ORANGE 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 Level | 1 (Verified on 04/15/2019) |
Sample Information
| Sample Taken Date | 10/21/2020 | Sample Unique Key | 1 |
|---|---|---|---|
| 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 testing | 10/23/2020 |
| Sample type | Authorization | A brief description of the sample | #8 A615 GR 75 Threaded Rebar |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Arthur | Last name of sampler or witnessed by | Peterson |
| Title of sampler | QAI | Telephone number of sampler | 707-342-8602 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Williams Form Engineering-SD | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L110-209-20 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM5 - Threaded Bar | Production or Authorization Testing | Authorization Testing |
|---|---|---|---|
| Threaded Bar Specification | ASTM A615 | Threaded Bar Grade | 75 |
| Threaded Bar Type | Plain | Rebar Size | #8 |
| Nut Specification for Threaded Bar | ASTM A108 | System Manufacturer | NA |
| Epoxy Coating Color | NA | Threaded Bar Application | Soil Nail |
| Coating Standards | Uncoated | Bar Heat Number(s) | 100103483 |
| Nut Heat Number(s) | 8299543 | Bar Lot Number | 10010348320 |
| Nut Lot Number | 8T1D | Coupler Heat Number(s) | NA |
| Coupler Grade | NA |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2020-10-21-1-1 ASTM A615-15 (Verified)
DIME Test ID: 2020-10-21-1-2 ASTM A615-15 (Verified)