Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2021-07-09-2
Sample is locked from editing. info
Project Information
Project Identifiers | Project ID: 215188 DEA: 080F5434 EFIS: 0817000239 Permit Numbers: 0823NMC0369 |
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DIST-CO-RTE-PM | 08-RIV-I-15,SR-91-6.1-7.6 |
Award Date | 03/11/2020 |
Closeout Date | Not set |
Work Description | I-15 ELC: 15/91 Express Lanes Connector Project (ELC) |
Location Description | Junction of I-15 and SR-91 in Corona, CA |
QA Service Level | 1 (Verified on 09/16/2020) |
Sample Information
Sample Taken Date | 07/09/2021 | Sample Unique Key | 2 |
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Will the laboratory/organization for which you are a member perform testing on this material sample? | Yes | Date that the sample was received by the laboratory/organization performing the testing | 07/16/2021 |
Sample type | Quality Assurance | A brief description of the sample | A615 Grade 75 Threaded Bar |
The quantity of what the sample constitutes | Heat 100108100 | From where was the sample collected | Manufacturer |
First name of sampler or witnessed by | David | Last name of sampler or witnessed by | Weeks |
Title of sampler | ASI | Telephone number of sampler | 310-883-8369 |
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | Williams Form Engineering Golden, CO | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | L79-032-21 | Structure unique identifier | |
Structure name | RW No 5 |
Material Information
Material Type | SMTL TM5 - Threaded Bar | Production or Authorization Testing | Production Testing |
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Threaded Bar Specification | ASTM A615 | Threaded Bar Grade | 75 |
Threaded Bar Type | Deformed | Rebar Size | #9 |
Nut Specification for Threaded Bar | ASTM A108 | System Manufacturer | Williams Form Engineering |
Epoxy Coating Color | NA | Threaded Bar Application | Soil Nail |
Coating Standards | Uncoated | Bar Heat Number(s) | 100108100 |
Nut Heat Number(s) | 8391467 | Bar Lot Number | NA |
Nut Lot Number | 9L3D | Coupler Heat Number(s) | NA |
Coupler Grade | NA |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2021-07-09-2-1 ASTM A615-15 (Verified)
DIME Test ID: 2021-07-09-2-2 ASTM A615-15 (Verified)
DIME Test ID: 2021-07-09-2-3 ASTM A615-15 (Verified)