Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2021-09-22-1
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215164 DEA: 07317304 EFIS: 0715000237 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-60-0.0/R3.2,11.8/R21.5 |
| Award Date | Not set |
| Closeout Date | 08/01/2023 |
| Work Description | UPGRADE EXISTING OVERHEAD AND ROADSIDE SIGN PANELS. |
| Location Description | LOS ANGELS COUNTY FROM 0.4 MILE WEST OF ROUTE 5/60 SEPARATION TO ROUTE 60/710 SEPARATION AND FROM ROUTE 60/605 SEPARATION TO FAIRWAY DRIVE UNDERCROSSING |
| QA Service Level | 1 (Verified on 02/18/2021) |
Sample Information
| Sample Taken Date | 09/22/2021 | Sample Unique Key | 1 |
|---|---|---|---|
| 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 testing | 09/29/2021 |
| Sample type | Quality Assurance | A brief description of the sample | Prequalification |
| The quantity of what the sample constitutes | (4) #6 ZAP Screwlok Type 2 Series (SL-17-03) | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Rigoberto | Last name of sampler or witnessed by | Marin |
| Title of sampler | Telephone number of sampler | 9515000685 | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Camblin Steel Service | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L133-111-21 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM5 - Couplers | Production or Authorization Testing | Authorization Testing |
|---|---|---|---|
| Service or Ultimate | Ultimate | Material Standard Code | ASTM A706 |
| Material Grade | 60 | Rebar Manufacturer | Nucor |
| Coupler Manufacturer | Zap Screwlok SL | Intermediate Assembler or Fabricator | |
| Rebar Size | #6 | Coupler Model | SL-17-03 |
| Coating Standards | Uncoated | Shape of Rebar | Straight |
| Rebar Hoop Diameter | Rebar Hoop Fabricator | ||
| Coupler Component Heat/Lot Number(s) | 74117560 | Rebar Heat Number(s) | 6024758 |
| Rebar Size 2 | 6 | Coupler Unique ID | Not set |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||