Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2021-07-07-1

Project Information

Project IdentifiersProject ID: 208973
DEA: 120H1004
EFIS: 1200000180
COOP: 120670
DIST-CO-RTE-PM12-ORA-405,73,405,605-9.3/24.3
Award Date11/07/2016
Closeout DateNot set
Work Description(Alternative Delivery) San Diego Freeway (I-405) Improvement Project SR-73 to I-605, Design Build Project, Administered by Orange County Transportation Authority, Caltrans METS to perform Source Inspection per RFP.
Location DescriptionOrange and Los Angeles Counties: 12-ORA-405 PM 9.3/24.2 / 07-LA-405 PM 0.0/1.2 12-ORA-22 PM R0.7/R3.8 / 12-ORA-22 PM R0.5/R0.7 12-ORA-73 PM R27.2/R27.8 / 12-ORA-605 PM 3.5/R1.6 07-LA-605 PM R0.0/R1.2
QA Service Level1 (Verified on 09/10/2015)

Sample Information

Sample Taken Date07/07/2021 Sample Unique Key1
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 sampleUBS Hoops
The quantity of what the sample constitutes442 Hoops From where was the sample collectedFabricator
First name of sampler or witnessed byDavid Last name of sampler or witnessed byWeeks
Title of samplerASI Telephone number of sampler3108838369
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCMC Etiwanda Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL79-029-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateUltimate Rebar Heat Number(s)3104852
Hoop Manufacturer Lot Number(s)8, 9, 10, and 11 Material Standard CodeASTM A706
Material Grade60 Rebar Size#8
Diameter of Hoop10'-9.5" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerCMC Texas
Welding CompanyCMC Etiwanda 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