Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2021-03-09-2

Project Information

Project IdentifiersProject ID: 214579
DEA: 010B0904
EFIS: 0100020444
DIST-CO-RTE-PM01-DN-101-8.2/8.7
Award Date04/21/2020
Closeout DateNot set
Work DescriptionBRIDGE REPLACEMENT
Location DescriptionDEL NORTE COUNTY NEAR KLAMATH AT PANTHER CREEK BRIDGE AND AT HUNTER CREEK BRIDGE
QA Service Level1 (Verified on 03/02/2020)

Sample Information

Sample Taken Date03/09/2021 Sample Unique Key2
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 Headed Bar
The quantity of what the sample constitutes824 EA From where was the sample collectedFabricator
First name of sampler or witnessed byDavid Last name of sampler or witnessed byWeeks
Title of samplerASI Telephone number of sampler310 883 8369
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHRC Fountain Valley Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL79-011-21 Structure unique identifier01-0085
Structure namePanther Creek

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)6018658, 4104357, 4099702 Head Manufacturer Lot Number(s)1,2,3,4,5, and 6
Rebar Size#6 Headed Bar Model NameHRC 150 Heat No 100104524
Size of HeadFull Size - 9x Head Connection TypeFriction Weld
Head ShapeCircular Rebar ManufacturerCMC
Head ManufacturerHRC Head FabricatorHRC
Material Standard CodeASTM A706

Submitted Tests

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