Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2021-10-26-8

Project Information

Project IdentifiersProject ID: 215164
DEA: 07317304
EFIS: 0715000237
DIST-CO-RTE-PM07-LA-60-0.0/R3.2,11.8/R21.5
Award DateNot set
Closeout DateNot set
Work DescriptionUPGRADE EXISTING OVERHEAD AND ROADSIDE SIGN PANELS.
Location DescriptionLOS 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 Level1 (Verified on 02/18/2021)

Sample Information

Sample Taken Date10/26/2021 Sample Unique Key8
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 testing11/02/2021
Sample typeQuality Control A brief description of the sample(16) #6 ZAP Coupler
The quantity of what the sample constitutes(16) #6 ZAP Coupler From where was the sample collectedFabricator
First name of sampler or witnessed byRigoberto Last name of sampler or witnessed byMarin
Title of samplerAMR 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) FormL133-122-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingProduction Testing
Service or UltimateUltimate Material Standard CodeASTM A706
Material Grade60 Rebar ManufacturerCmc
Coupler ManufacturerSingle Row ZAP Screwlok Type 2 Series Intermediate Assembler or FabricatorCamblin Steel
Rebar Size#6 Coupler ModelZap Screwlok Type 2
Coating StandardsUncoated Shape of RebarStraight
Rebar Hoop Diameter Rebar Hoop Fabricator
Coupler Component Heat/Lot Number(s)74117560 Rebar Heat Number(s)4111931
Rebar Size 2 6 Coupler Unique IDNot set

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments