Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2021-02-03-5

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 Date02/03/2021 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 testingNot set
Sample typeQuality Control A brief description of the sample#6 button headed bar
The quantity of what the sample constitutes4 Headed Bars from lot 1 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 nameCamblin Steel Service Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL123-023-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)6019603 Head Manufacturer Lot Number(s)13G2
Rebar Size#6 Headed Bar Model NameBNX Buttonhead
Size of HeadFull Size - 9x Head Connection TypeForged
Head ShapeCircular Rebar ManufacturerCMC Steel California
Head ManufacturerBar Splice Products Head FabricatorBar Splice
Material Standard CodeASTM A706 Headed Bar Unique IDNot set

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