Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2021-06-29-12

Project Information

Project IdentifiersProject ID: 214951
DEA: 120K0234
EFIS: 1214000100
DIST-CO-RTE-PM12-ORA-5-17.1/18.9
Award Date09/23/2020
Closeout DateNot set
Work DescriptionSouth County Improvement Project (Phase 3 - El Toro/Alicia) WIDEN FREEWAY AND BRIDGES, RECONSTRUCT BRIDGE AND WALLS.
Location DescriptionORANGE COUNTY IN MISSION VIEJO, LAGUNA HILLS, LAGUNA WOODS AND LAKE FOREST FROM 0.4 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING TO 0.2 MILE NORTH OF EL TORO ROAD UNDERCROSSING
QA Service Level1 (Verified on 10/01/2020)

Sample Information

Sample Taken Date06/29/2021 Sample Unique Key12
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 Control A brief description of the sample#5 x 2'-2" dia.
The quantity of what the sample constitutes8 hoops From where was the sample collectedFabricator
First name of sampler or witnessed byOsiel Last name of sampler or witnessed byRamirez
Title of sampler Telephone number of sampler5599740870
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) FormL123-075-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateUltimate Rebar Heat Number(s)1201022826
Hoop Manufacturer Lot Number(s)Lot 1-2 Material Standard CodeASTM A706
Material Grade60 Rebar Size#5
Diameter of Hoop2'-2" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerNucor
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