Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2021-09-22-4
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 213750 DEA: 120K0224 EFIS: 1214000097 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-5-14.5/17.1 |
| Award Date | 03/05/2019 |
| Closeout Date | Not set |
| Work Description | South County Improvement Project (Phase 2 - Oso/Alicia) CONST BRIDGES, RW, SW, HMA PVMT, JPCP, DRAINAGE, AND ELECT SYSTEMS. |
| Location Description | ORANGE COUNTY IN MISSION VIEJO AND LAGUNA HILLS FROM 0.7 MILE SOUTH OF OSO PARKWAY OVERCROSSING TO 0.3 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING |
| QA Service Level | 1 (Verified on 04/15/2019) |
Sample Information
| Sample Taken Date | 09/22/2021 | Sample Unique Key | 4 |
|---|---|---|---|
| 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 | 09/22/2021 |
| Sample type | Quality Control | A brief description of the sample | #9 BNX Buttonhead (9CS-17-01) |
| The quantity of what the sample constitutes | (4) #9 BNX Buttonhead (9CS-17-01) | 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 | Integrity Rebar | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L133-113-21 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM5 - Headed Bars | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Rebar Heat Number(s) | 2110991 | Head Manufacturer Lot Number(s) | A201714 |
| Rebar Size | #9 | Headed Bar Model Name | BPI Bottonhead 10AB |
| Size of Head | Full Size - 9x | Head Connection Type | Forged |
| Head Shape | Circular | Rebar Manufacturer | Vinton Steel |
| Head Manufacturer | Integrity Rebar | Head Fabricator | Barsplice BNX Buttonheads |
| Material Standard Code | ASTM A706 | Headed Bar 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. | |||