Sample Record
Owner Lab
- CT HQ - QASI Sacramento Field Office
DIME Sample ID 2021-05-21-3
Sample is locked from editing. info
Project Information
Project Identifiers | Project ID: 214579 DEA: 010B0904 EFIS: 0100020444 |
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DIST-CO-RTE-PM | 01-DN-101-8.2/8.7 |
Award Date | 04/21/2020 |
Closeout Date | Not set |
Work Description | Panther Creek & Hunter Creek Bridges |
Location Description | DEL NORTE COUNTY NEAR KLAMATH AT PANTHER CREEK BRIDGE AND AT HUNTER CREEK BRIDGE |
QA Service Level | 1 (Verified on 03/02/2020) |
Sample Information
Sample Taken Date | 05/21/2021 | Sample Unique Key | 3 |
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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 testing | 05/21/2021 |
Sample type | Quality Assurance | A brief description of the sample | Dayton Superior D101 Form Savers |
The quantity of what the sample constitutes | 20 | From where was the sample collected | Fabricator |
First name of sampler or witnessed by | Sherri | Last name of sampler or witnessed by | Brannon |
Title of sampler | QA Inspector | Telephone number of sampler | 916-826-6371 |
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | PJs Rebar | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | B22-036-21 | Structure unique identifier | |
Structure name |
Material Information
Material Type | SMTL TM5 - Couplers | Production or Authorization Testing | Production Testing |
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Service or Ultimate | Ultimate | Material Standard Code | ASTM A706 |
Material Grade | 60 | Rebar Manufacturer | Nucor |
Coupler Manufacturer | Superior D101 Form Savers | Intermediate Assembler or Fabricator | PJs Rebar |
Rebar Size | #5 | Coupler Model | Superior D101 Form Savers |
Coating Standards | Uncoated | Shape of Rebar | Straight |
Rebar Hoop Diameter | Rebar Hoop Fabricator | ||
Coupler Component Heat/Lot Number(s) | x | Rebar Heat Number(s) | 3500016013 |
Rebar Size 2 | 5 | Coupler Unique ID | Not set |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2021-05-21-3-1 CTM 670-December 2013 (Verified)
DIME Test ID: 2021-05-21-3-2 CTM 670-December 2013 (Verified)
DIME Test ID: 2021-05-21-3-3 CTM 670-December 2013 (Verified)