Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2021-06-14-2

Project Information

Project IdentifiersProject ID: 213749
DEA: 120C1104
EFIS: 1200000633
DIST-CO-RTE-PM12-ORA-57-20.3/21.6
Award Date04/19/2019
Closeout DateNot set
Work DescriptionSR-57 Lambert Interchange Project: WIDEN BRIDGES AND CONSTRUCT RW, SW, HMA, JPCP AND ELECTRICAL SYSTEMS.
Location DescriptionORANGE COUNTY IN BREA FROM 0.6 MILE SOUTH TO 0.7 MILE NORTH OF LAMBERT ROAD UNDERCROSSING
QA Service Level1 (Verified on 05/31/2019)

Sample Information

Sample Taken Date06/14/2021 Sample Unique Key2
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 testing06/15/2021
Sample typeQuality Control A brief description of the sample#7 3'-8" Welded Hoops
The quantity of what the sample constitutes44 From where was the sample collectedFabricator
First name of sampler or witnessed byBrandon Last name of sampler or witnessed byQuintana
Title of sampler Telephone number of sampler8582850576
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameRKR Steel Welding Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingAuthorization Testing
Service or UltimateUltimate Rebar Heat Number(s)039421
Hoop Manufacturer Lot Number(s)1 Material Standard CodeASTM A706
Material Grade60 Rebar Size#7
Diameter of Hoop3'-8" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerCascade Steel
Welding CompanyRKR Steel Welding Coating StandardsUncoated
Weld TypeFlash Welded

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