Sample Record

Owner Lab

  • CT HQ - QASI Sacramento Field Office

DIME Sample ID 2021-11-09-2

Project Information

Project IdentifiersProject ID: 215063
DEA: 032F5704
EFIS: 0300020615
DIST-CO-RTE-PM03-PLA-80-46.3/63.5
Award Date09/23/2020
Closeout Date08/11/2023
Work DescriptionReplace 4 Bridges (OC) on Highway 80 from Crystal Springs to Cisco Grove (Baxter, Drum Forebay)
Location DescriptionNot set
QA Service Level1 (Verified on 11/16/2020)

Sample Information

Sample Taken Date11/09/2021 Sample Unique Key2
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 typeQuality Assurance A brief description of the sample#6 bar epoxy coated
The quantity of what the sample constitutes2 From where was the sample collectedFabricator
First name of sampler or witnessed byGordon Last name of sampler or witnessed byLivermore
Title of samplerCT METS QA INSPECTOR Telephone number of sampler916-753-0227
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameAmerican Highway - Simplex Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM7 - Epoxy Coated Rebar Rebar Heat Number(s)120236445
Rebar Epoxy Batch Number(s)3ch2010021, 3ch2041027 Rebar Coating SpecificationASTM A934
Rebar Size (#)6 Rebar Coating ColorPurple
Rebar ManufacturerNucor Rebar CoaterAmerican Highway
Rebar Powder ManufacturerSherwin Williams Release Number
Quality Assurance Code

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