Sample Record

Owner Lab

  • CT QASI - Sacramento Field Laboratory

DIME Sample ID 2021-07-01-3

Project Information

Project IdentifiersProject ID: 215424
DEA: 024G4404
EFIS: 0214000013
DIST-CO-RTE-PM02-SIS-3-38.0/38.6
Award Date03/22/2021
Closeout DateNot set
Work DescriptionBRIDGE REPLACEMENT
Location DescriptionSISKIYOU COUNTY ABOUT 6 MILES NORTH OF FORT JONES FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF LOWER MOFFETT CREEK ROAD
QA Service Level1 (Verified on 01/19/2021)

Sample Information

Sample Taken Date07/01/2021 Sample Unique Key3
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 Assurance A brief description of the sample#5 epoxy coated formsaver couplers
The quantity of what the sample constitutes2 lots From where was the sample collectedFabricator
First name of sampler or witnessed byJane Last name of sampler or witnessed byLillard
Title of samplerCALTRANS QA INSPECTOR Telephone number of sampler916-291-8042
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCon-Fab California, LLC Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormS52-027-21 Structure unique identifier
Structure nameExterior girders M1, M3

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingProduction Testing
Service or UltimateService Material Standard CodeASTM A706
Material Grade60 Rebar ManufacturerNucor
Coupler ManufacturerErico Lenton Intermediate Assembler or FabricatorConFab Lathrop
Rebar Size#5 Coupler ModelELC16FS2
Coating StandardsASTM A775 epoxy Shape of RebarStraight
Rebar Hoop Diameter Rebar Hoop Fabricator
Coupler Component Heat/Lot Number(s)Erico lot A1289 and 9830 Rebar Heat Number(s)3600019380
Rebar Size 2 5

Submitted Tests

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