Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2021-03-08-6

Project Information

Project IdentifiersProject ID: 214909
DEA: 120N8604
EFIS: 1214000123
DIST-CO-RTE-PM12-ORA-73-23.7/24.1
Award Date06/25/2020
Closeout DateNot set
Work DescriptionREPLACE STRUCTURAL CONCRETE BRIDGE & RETAINING WALL; & PLACE HMA.
Location DescriptionORANGE COUNTY IN NEWPORT BEACH FROM 0.3 MILE NORTH OF BISON AVENUE TO 0.3 MILE SOUTH OF UNIVERSITY DRIVE
QA Service Level1 (Verified on 07/21/2020)

Sample Information

Sample Taken Date03/08/2021 Sample Unique Key6
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#7 4'-8" diameter welded hoops
The quantity of what the sample constitutes50 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) FormL134-041-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateUltimate Rebar Heat Number(s)4105364
Hoop Manufacturer Lot Number(s)1 Material Standard CodeASTM A706
Material Grade60 Rebar Size#7
Diameter of Hoop4'-8" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerCMC Arizona
Welding CompanyCMC Etiwanda Coating StandardsUncoated
Weld TypeFlash Welded

Submitted Tests

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