Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2021-05-27-14
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 | 05/27/2021 | Sample Unique Key | 14 |
|---|---|---|---|
| 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 | Dayton Superior D101A Dowel Bar (SF-17-01) |
| The quantity of what the sample constitutes | (16) #5 D101A Dowel Bar (D-B) | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Rigoberto | Last name of sampler or witnessed by | Marin |
| Title of sampler | AMR | Telephone number of sampler | 951-500-0685 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Coreslab Structures L A Inc | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L133-064-21 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM5 - Couplers | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Service or Ultimate | Service | Material Standard Code | ASTM A706 |
| Material Grade | 60 | Rebar Manufacturer | Nucor |
| Coupler Manufacturer | Dayton Superior | Intermediate Assembler or Fabricator | Coreslab Structures L A Inc |
| Rebar Size | #5 | Coupler Model | SF-17-01 |
| Coating Standards | Uncoated | Shape of Rebar | Straight |
| Rebar Hoop Diameter | NA | Rebar Hoop Fabricator | NA |
| Coupler Component Heat/Lot Number(s) | 128314 | Rebar Heat Number(s) | 3500014854 |
| Rebar Size 2 | 5 | Coupler 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. | |||