Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2021-10-08-3

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 Date10/08/2021 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 testing10/08/2021
Sample typeQuality Assurance A brief description of the sample(16) #8 HRC 555
The quantity of what the sample constitutes4 From where was the sample collectedManufacturer
First name of sampler or witnessed byRigoberto Last name of sampler or witnessed byMarin
Title of sampler Telephone number of sampler9515000685
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) FormL133-119-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)2121269 Head Manufacturer Lot Number(s)Lot 1
Rebar Size#8 Headed Bar Model NameHRC 555
Size of HeadReduced Size - 4x Head Connection TypeForged
Head ShapeCircular Rebar ManufacturerVinton Steel
Head ManufacturerCamblin Steel Head FabricatorCamblin Steel
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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Test File Attachments