Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2021-10-19-16
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 213099 DEA: 041A6614 EFIS: 0415000291 COOP: 042683A1 |
|---|---|
| DIST-CO-RTE-PM | 04-MRN-101-8.4 |
| Award Date | 11/30/2020 |
| Closeout Date | 12/12/2023 |
| Work Description | CONSTRUCTION ON STATE HIGHWAY IN MARIN COUNTY IN LARKSPUR |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 11/06/2020) |
Sample Information
| Sample Taken Date | 10/19/2021 | Sample Unique Key | 16 |
|---|---|---|---|
| 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 | Not set |
| Sample type | Quality Assurance | A brief description of the sample | 3/4" Threaded Rod Assembly |
| The quantity of what the sample constitutes | 1 lot | From where was the sample collected | Distributor |
| First name of sampler or witnessed by | Ryan | Last name of sampler or witnessed by | Parr |
| Title of sampler | ASI | Telephone number of sampler | 510-385-5910 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Pacific Bolt | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | B373-099-21 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM5 - Threaded Bar | Production or Authorization Testing | Authorization Testing |
|---|---|---|---|
| Threaded Bar Specification | ASTM A706 | Threaded Bar Grade | 36 |
| Threaded Bar Type | Plain | Rebar Size | |
| Nut Specification for Threaded Bar | ASTM A194-2H | System Manufacturer | Pacific Bolt |
| Epoxy Coating Color | NA | Threaded Bar Application | Threaded Bar |
| Coating Standards | ASTM A153 galvanized | Bar Heat Number(s) | 142120 |
| Nut Heat Number(s) | 438509A | Bar Lot Number | |
| Nut Lot Number | Coupler Heat Number(s) | 365171Z | |
| Coupler Grade |
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. | |||