Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2020-12-10-11

Project Information

Project IdentifiersProject ID: 213469
DEA: 024C40V4
EFIS: 0218000125
DIST-CO-RTE-PM02-SHA-5-R3.8/R11.7
Award Date11/06/2018
Closeout Date08/16/2023
Work DescriptionWIDEN TO 6 LANES, BRIDGE REPLACEMENT AND WIDENING AND ROADWAY REHAB
Location DescriptionSHASTA COUNTY IN AND NEAR ANDERSON FROM ROUTE 5/273 SEPARATION TO 0.4 MILE SOUTH OF CHURN CREEK ROAD OVERCROSSING
QA Service Level1 (Verified on 12/31/2018)

Sample Information

Sample Taken Date12/10/2020 Sample Unique Key11
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#8 (4'-2")
The quantity of what the sample constitutes140 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 nameCMC Etiwanda Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL134-290-20 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateUltimate Rebar Heat Number(s)4098936
Hoop Manufacturer Lot Number(s)27 Material Standard CodeASTM A706
Material Grade60 Rebar Size#8
Diameter of Hoop4'-2" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerCMC Steel AZ
Welding CompanyCMC Rebar (Etiwanda) Coating StandardsUncoated
Weld TypeFlash Welded

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