Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2021-07-08-2

Project Information

Project IdentifiersProject ID: 214993
DEA: 051F5004
EFIS: 0514000003
DIST-CO-RTE-PM05-SB-101,135-70.6/71.2;0.1
Award Date11/17/2020
Closeout Date01/11/2024
Work DescriptionCONSTRUCT CONCRETE BRIDGE, BRIDGE REMOVAL, COLD PLANE, PLACE HMA.
Location DescriptionSANTA BARBARA COUNTY AT LOS ALAMOS ON ROUTE 101 FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF ROUTE 101/135 SEPARATION AND ON ROUTE 135 AT ROUTE 101/135 SEPARATION
QA Service Level1 (Verified on 09/03/2020)

Sample Information

Sample Taken Date07/08/2021 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 testingNot set
Sample typeQuality Control A brief description of the sample#11 headed rebar
The quantity of what the sample constitutes28 From where was the sample collectedManufacturer
First name of sampler or witnessed bySteve Last name of sampler or witnessed byHall
Title of samplerCT METS QA INSPECTOR Telephone number of sampler6466327821
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHeaded Reinforcement Corp, Fountain Valley, CA Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL134-109-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)3500015879 Head Manufacturer Lot Number(s)1
Rebar Size#11 Headed Bar Model NameHRC 120 T Heads
Size of HeadFull Size - 9x Head Connection TypeFriction Weld
Head ShapeSquare Rebar ManufacturerNucor Seattle
Head ManufacturerHeaded Reinforcement Corp Head FabricatorHeaded Reinforcement Corp
Material Standard CodeASTM A706 Headed Bar Unique IDNot set

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