Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2021-02-19-24

Project Information

Project IdentifiersProject ID: 214937
DEA: 11288834
EFIS: 1117000088
DIST-CO-RTE-PM11-SD-11,125,905-various
Award DateNot set
Closeout DateNot set
Work DescriptionCONSTRUCT CONCRETE BRIDGE, PAVEMENT, BARRIER, AND INSTALL LIGHTING. HPLUL-6211(133) SR-125 SB to WB SR-905
Location DescriptionSAN DIEGO COUNTY IN AND NEAR SAN DIEGO AT ROUTE 11/125/905 SEPARATION
QA Service Level1 (Verified on 09/04/2020)

Sample Information

Sample Taken Date02/19/2021 Sample Unique Key24
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#14 HRC Type 555
The quantity of what the sample constitutes4 From where was the sample collectedFabricator
First name of sampler or witnessed byRigoberto Last name of sampler or witnessed byMarin
Title of samplerQAI Telephone number of sampler951-500-0685
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCMC Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL133-018-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingAuthorization Testing
Rebar Heat Number(s)1066919 Head Manufacturer Lot Number(s)Lot 1
Rebar Size#14 Headed Bar Model NameType 555
Size of HeadReduced Size - 4x Head Connection TypeForged
Head ShapeCircular Rebar ManufacturerCMC Steel CA
Head ManufacturerHRC Head FabricatorCMC San Bernardino
Material Standard CodeASTM A706

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.