Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2021-08-31-3

Project Information

Project IdentifiersProject ID: 213099
DEA: 041A6614
EFIS: 0415000291
COOP: 042683A1
DIST-CO-RTE-PM04-MRN-101-8.4
Award Date11/30/2020
Closeout Date12/12/2023
Work DescriptionCONSTRUCTION ON STATE HIGHWAY IN MARIN COUNTY IN LARKSPUR
Location DescriptionNot set
QA Service Level1 (Verified on 11/06/2020)

Sample Information

Sample Taken Date08/31/2021 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 testing09/07/2021
Sample typeQuality Control A brief description of the sample# Lenton Threaded Bar Coupler
The quantity of what the sample constitutesLot 1, Lot 2, Lot 3, Lot 4, Lot 5 From where was the sample collectedFabricator
First name of sampler or witnessed byPaul Last name of sampler or witnessed byShrestha
Title of samplerQA Inspector Telephone number of sampler(424) 298-7781
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCamblin Steel Service Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL108-011-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingProduction Testing
Service or UltimateService Material Standard CodeASTM A615
Material Grade60 Rebar ManufacturerVinton Steel
Coupler ManufacturerErico International Intermediate Assembler or Fabricator
Rebar Size#5 Coupler ModelLenton Form Saver
Coating StandardsUncoated Shape of RebarStraight
Rebar Hoop Diameter Rebar Hoop Fabricator
Coupler Component Heat/Lot Number(s)202040/9830 Rebar Heat Number(s)2121471, 2121499, 2121500
Rebar Size 2 Coupler 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