Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2021-04-02-2

Project Information

Project IdentifiersProject ID: 214841
DEA: 034H1004
EFIS: 0318000176
DIST-CO-RTE-PM03-SIE-49-9.2/24.7
Award Date05/29/2020
Closeout Date07/29/2022
Work DescriptionINSTALL RETAINING STRUCTURE AND RSP CONCRETE EMBANKMENT.
Location DescriptionSIERRA COUNTY ON ROUTE 49 AT VARIOUS LOCATIONS
QA Service Level1 (Verified on 03/24/2020)

Sample Information

Sample Taken Date04/02/2021 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 HRC 555 Reduced Size
The quantity of what the sample constitutes(4) #6 HRC 555 Reduced Size 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 namePacific Steel Group Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL133-048-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)1202029290 Head Manufacturer Lot Number(s)Lot 1
Rebar Size#6 Headed Bar Model NameHCR Type 555
Size of HeadReduced Size - 4x Head Connection TypeForged
Head ShapeCircular Rebar ManufacturerNucor
Head ManufacturerPacific Steel Group Head FabricatorPacific Steel Group
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