Sample Record

Owner Lab

  • CT QASI - Sacramento Field Laboratory

DIME Sample ID 2021-05-21-2

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 Date05/21/2021 Sample Unique Key2
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing05/21/2021
Sample typeQuality Control A brief description of the sampleDayton Superior D101 Form Savers
The quantity of what the sample constitutes44 From where was the sample collectedFabricator
First name of sampler or witnessed bySherri Last name of sampler or witnessed byBrannon
Title of samplerQA Inspector Telephone number of sampler916-826-6371
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility namePJs Rebar Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormB22--035-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingProduction Testing
Service or UltimateUltimate Material Standard CodeASTM A706
Material Grade60 Rebar ManufacturerNucor
Coupler ManufacturerDayton Superior Intermediate Assembler or FabricatorPJs Rebar
Rebar Size#4 Coupler ModelD101 Form Savers
Coating StandardsUncoated Shape of RebarStraight
Rebar Hoop Diameter Rebar Hoop Fabricator
Coupler Component Heat/Lot Number(s)x Rebar Heat Number(s)0650015352
Rebar Size 2 4

Submitted Tests

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