Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2021-10-25-5

Project Information

Project IdentifiersProject ID: 215396
DEA: 042K8404
EFIS: 0417000031
DIST-CO-RTE-PM04-SOL-29,80-0.0,0.8/1.6
Award Date03/26/2021
Closeout Date02/16/2024
Work DescriptionHMA, STRUCTURAL CONCRETE, CIDH PILING AND REBAR.
Location DescriptionSOLANO COUNTY IN VALLEJO AT ROUTE 80/29 SEPARATION AND ON ROUTE 80 FROM 0.2 MILE NORTH OF CARQUINEZ BRIDGE TOLL PLAZA TO 0.3 MILE SOUTH OF MAGAZINE STREET OVERCROSSING
QA Service Level1 (Verified on 01/25/2021)

Sample Information

Sample Taken Date10/25/2021 Sample Unique Key5
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 testingNot set
Sample typeAcceptance A brief description of the sample#5 Lenton Formsaver Coupler
The quantity of what the sample constitutes32 From where was the sample collectedSource
First name of sampler or witnessed byKevin Last name of sampler or witnessed byCarpenter
Title of sampler Telephone number of sampler14156081742
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameConco Reinforcing Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormB24-090-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingAuthorization Testing
Service or UltimateService Material Standard CodeASTM A706
Material Grade60 Rebar Manufacturer#5
Coupler ManufacturerErico Lenton Intermediate Assembler or FabricatorConco
Rebar Size#5 Coupler ModelLenton Formsaver
Coating StandardsUncoated Shape of RebarStraight
Rebar Hoop Diameter Rebar Hoop Fabricator
Coupler Component Heat/Lot Number(s)1234 Rebar Heat Number(s)1234
Rebar Size 2 5 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