Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2020-12-01-1

Project Information

Project IdentifiersProject ID: 213856
DEA: 112888U4
EFIS: 1118000199
DIST-CO-RTE-PM11-SD-11,125,905-Various
Award DateNot set
Closeout DateNot set
Work DescriptionCONSTRUCT FREEWAY TO FREEWAY CONNECTORS AND 4-LANE HIGHWAY FACILITY
Location DescriptionSAN DIEGO COUNTY AT VARIOUS LOCATIONS
QA Service Level1 (Verified on 07/19/2019)

Sample Information

Sample Taken Date12/01/2020 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 sampleNo 11 Headed Reinforcement
The quantity of what the sample constitutes1 Lot of 74 Headed Bars From where was the sample collectedFabricator
First name of sampler or witnessed byDavid Last name of sampler or witnessed byWeeks
Title of samplerASI Telephone number of sampler310-883-8369
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameIntegrity Rebar Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL79-068-20 Structure unique identifier
Structure nameAlta Road Overcrossing

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)65029069 Head Manufacturer Lot Number(s)2N1
Rebar Size#11 Headed Bar Model NameButtonhead BNX
Size of HeadFull Size - 9x Head Connection TypeCrimped Head
Head ShapeCircular Rebar ManufacturerGerdau
Head ManufacturerBar Splice Head FabricatorIntegrity Rebar
Material Standard CodeASTM A706

Submitted Tests

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