Sample Record

Owner Lab

  • G3 Quality, Incorporated - Cerritos

DIME Sample ID 2021-09-22-71

Project Information

Project IdentifiersProject ID: 212112
DEA: 080C2514
EFIS: 0816000076
COOP: 081645
DIST-CO-RTE-PM08-SBD-10-0.0/13.2
Award Date06/06/2018
Closeout DateNot set
Work DescriptionDesign-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes
Location DescriptionLA/SBD County Line to PM 13.2 near I-15
QA Service Level1 (Verified on 10/16/2019)

Sample Information

Sample Taken Date09/22/2021 Sample Unique Key71
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 testing10/29/2021
Sample typePer Request A brief description of the sample#5 Lenton Coupler
The quantity of what the sample constitutes3 From where was the sample collectedJob Site
First name of sampler or witnessed byNestor Last name of sampler or witnessed byAlverez
Title of samplerInspector Telephone number of sampler(909) 649-7610
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCMC Rebar Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameVineyard

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingProduction Testing
Service or UltimateService Material Standard CodeASTM A706
Material Grade60 Rebar ManufacturerCMC Rebar
Coupler ManufacturerLenton Intermediate Assembler or Fabricator
Rebar Size#5 Coupler ModelLenton Form Saver
Coating StandardsUncoated Shape of RebarStraight
Rebar Hoop Diameter Rebar Hoop Fabricator
Coupler Component Heat/Lot Number(s)Heat 202040 lot 9867 Rebar Heat Number(s)4110165
Rebar Size 2 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