Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2020-11-24-5
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Project Information
| Project Identifiers | Project ID: 214586 DEA: 081H7704 EFIS: 0817000132 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-215-4.5/5.8 |
| Award Date | 06/10/2020 |
| Closeout Date | 05/26/2022 |
| Work Description | INSTALL SIGN STRUCTURE, HMA, MODIFY RAMP METERING AND RETAINING WALL. |
| Location Description | SAN BENARDINO COUNTY IN SAN BERNARDINO FROM 0.5 MILE SOUTH OR ORANGE SHOW ROAD/AUTO PLAZA DRIVE OVERCROSSING TO 0.2 MILE NORTH OF INLAND CENTER DRIVE OVERCROSSING |
| QA Service Level | 1 (Verified on 04/16/2020) |
Sample Information
| Sample Taken Date | 11/24/2020 | Sample Unique Key | 5 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | Yes | Date that the sample was received by the laboratory/organization performing the testing | 11/30/2020 |
| Sample type | Quality Assurance | A brief description of the sample | #8 threaded bar |
| The quantity of what the sample constitutes | N/A | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Steve | Last name of sampler or witnessed by | Hall |
| Title of sampler | CT METS QA INSPECTOR | Telephone number of sampler | 6466327821 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Williams Form Engineering | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L134-279-20 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM5 - Threaded Bar | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Threaded Bar Specification | ASTM A615 | Threaded Bar Grade | 75 |
| Threaded Bar Type | Deformed | Rebar Size | #8 |
| Nut Specification for Threaded Bar | ASTM A108 | System Manufacturer | Williams Form Engineering |
| Epoxy Coating Color | NA | Threaded Bar Application | Soil Nail |
| Coating Standards | Uncoated | Bar Heat Number(s) | 100105605 |
| Nut Heat Number(s) | Bar Lot Number | ||
| Nut Lot Number | Coupler Heat Number(s) | ||
| Coupler Grade |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2020-11-24-5-1 ASTM A615-15 (Verified)
DIME Test ID: 2020-11-24-5-2 ASTM A615-15 (Verified)