Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2021-11-30-2
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215255 DEA: 040A7714 EFIS: 0420000287 |
|---|---|
| DIST-CO-RTE-PM | 04-ALA-80-6.4-6.6 |
| Award Date | 05/03/2021 |
| Closeout Date | 12/01/2023 |
| Work Description | CONSTRUCT PEDESTRIAN OVERCROSSING BRIDGE AND RETAINING WALLS. GILMAN INTERCHANGE IMPROVEMENTS |
| Location Description | ALAMEDA COUNTY IN BERKELEY FROM 0.6 MILE NORTH OF UNIVERSITY AVENUE OVERCROSSING TO 0.1 MILE SOUTH OF GILMAN STREET UNDERCROSSING |
| QA Service Level | 1 (Verified on 12/07/2020) |
Sample Information
| Sample Taken Date | 11/30/2021 | Sample Unique Key | 2 |
|---|---|---|---|
| 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 | 12/07/2021 |
| Sample type | Quality Control | A brief description of the sample | (4) #5 HRC 120 X 18'-0" |
| The quantity of what the sample constitutes | (11) #5 HRC 120 X 18'-0" | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Rigoberto | Last name of sampler or witnessed by | Marin |
| Title of sampler | Telephone number of sampler | 9515000685 | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | HRC Fountain Valley | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L133-127-21 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM5 - Headed Bars | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Rebar Heat Number(s) | 4111735 | Head Manufacturer Lot Number(s) | LOT 1 |
| Rebar Size | #5 | Headed Bar Model Name | HRC 120 9FW 17 03 |
| Size of Head | Full Size - 9x | Head Connection Type | Friction Weld |
| Head Shape | Square | Rebar Manufacturer | CMC Rebar |
| Head Manufacturer | NUCOR HRC HEAT NO 10021114224 | Head Fabricator | HRC |
| Material Standard Code | ASTM A706 | Headed Bar Unique ID | Not set |
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. | |||