Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2021-05-16-4

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 DescriptionPanther Creek & Hunter Creek Bridges
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 Date05/16/2021 Sample Unique Key4
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 Assurance A brief description of the sampleHeaded Bar
The quantity of what the sample constitutes20 From where was the sample collectedFabricator
First name of sampler or witnessed byChris Last name of sampler or witnessed byDsouza
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHRC Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)6021607 Head Manufacturer Lot Number(s)1
Rebar Size#9 Headed Bar Model NameHRC 150
Size of HeadFull Size - 9x Head Connection Type
Head ShapeCircular Rebar ManufacturerCMC
Head ManufacturerHRC Head FabricatorHRC
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