Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2021-01-13-5

Project Information

Project IdentifiersProject ID: 213653
DEA: 044G8204
EFIS: 0413000049
DIST-CO-RTE-PM04-MRN-101-10.6/10.8
Award Date05/05/2020
Closeout Date08/14/2023
Work DescriptionREPLACE SAN RAFAEL HARBOR BRIDGE (ABC)
Location DescriptionMARIN COUTY, IN SAN RAFAEL, FROM ROUTE 101 NORTHBOUND OFF-RAMP TO 2ND STREET
QA Service Level1 (Verified on 05/31/2019)

Sample Information

Sample Taken Date01/13/2021 Sample Unique Key5
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 testing01/15/2021
Sample typeQuality Control A brief description of the sample#5 Rebar 3'-5.25" dia. hoops
The quantity of what the sample constitutes8 hoops From where was the sample collectedFabricator
First name of sampler or witnessed byOsiel Last name of sampler or witnessed byRamirez
Title of samplerQuality Assurance Inspector Telephone number of sampler5599740870
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCMC Rebar Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL123-005-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateUltimate Rebar Heat Number(s)4103789
Hoop Manufacturer Lot Number(s)Lots 1-2 Material Standard CodeASTM A706
Material Grade60 Rebar Size#5
Diameter of Hoop3'-5.25" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerCMC Rebar and CMC Steel
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