Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2021-07-06-12

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 Date07/06/2021 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 testing07/07/2021
Sample typeQuality Control A brief description of the sampleWelded Hoops
The quantity of what the sample constitutes1560 From where was the sample collectedFabricator
First name of sampler or witnessed byBrandon Last name of sampler or witnessed byQuintana
Title of samplerAssistant METS Rep 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)1202024048
Hoop Manufacturer Lot Number(s)1-11 Material Standard CodeASTM A706
Material Grade60 Rebar Size#4
Diameter of Hoop1'-6" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerNucor
Welding CompanyCaltrans 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