Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2021-04-26-3
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214355 DEA: 120K0214 EFIS: 1214000096 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-5-12.4/14.5 |
| Award Date | 12/20/2019 |
| Closeout Date | Not set |
| Work Description | South County Improvement Project (Phase 1 - Avery/Crown Valley) PLACE HMA, INSTALL CONC PAVEMENT, RETAIN WALL, MODIFY ELECT SYS. | Add one lane btwn 73 & Oso PKWY |
| Location Description | ORANGE COUNTY IN SAN JUAN CAPISTRANO, LAGUNA HILLS, LAGUNA NIGUEL AND MISSION VIEJO FROM 0.5 MILE SOUTH OF AVERY PARKWAY UNDERCROSSING TO 0.8 MILE NORTH OF CROWN VALLEY PARKWAY OVERCROSSING |
| QA Service Level | 1 (Verified on 10/31/2019) |
Sample Information
| Sample Taken Date | 04/26/2021 | Sample Unique Key | 3 |
|---|---|---|---|
| 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 testing | Not set |
| Sample type | Quality Control | A brief description of the sample | #9 Button head headed bars |
| The quantity of what the sample constitutes | (4ea) #9 Heater Bars | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Osiel | Last name of sampler or witnessed by | Ramirez |
| Title of sampler | Quality Assurance Inspector | Telephone number of sampler | 5599740870 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Integrity Rebar | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L123-049-21 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM5 - Headed Bars | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Rebar Heat Number(s) | 1812754 | Head Manufacturer Lot Number(s) | 336266 |
| Rebar Size | #9 | Headed Bar Model Name | Barsplice Buttonhead BNX |
| Size of Head | Full Size - 9x | Head Connection Type | Forged |
| Head Shape | Circular | Rebar Manufacturer | Vinton Steel |
| Head Manufacturer | Integrity Rebar | Head Fabricator | Steel Dinamic Inc |
| Material Standard Code | ASTM A706 | Headed Bar Unique ID | Not set |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||