Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2021-11-30-9

Project Information

Project IdentifiersProject ID: 213750
DEA: 120K0224
EFIS: 1214000097
DIST-CO-RTE-PM12-ORA-5-14.5/17.1
Award Date03/05/2019
Closeout DateNot set
Work DescriptionSouth County Improvement Project (Phase 2 - Oso/Alicia) CONST BRIDGES, RW, SW, HMA PVMT, JPCP, DRAINAGE, AND ELECT SYSTEMS.
Location DescriptionORANGE COUNTY IN MISSION VIEJO AND LAGUNA HILLS FROM 0.7 MILE SOUTH OF OSO PARKWAY OVERCROSSING TO 0.3 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING
QA Service Level1 (Verified on 04/15/2019)

Sample Information

Sample Taken Date11/30/2021 Sample Unique Key9
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing12/02/2021
Sample typeQuality Assurance A brief description of the sample#8 BNX Buttonhead (9CS-17-01) Lot #1 ,QA Samples
The quantity of what the sample constitutes(4) #8 BNX Buttonhead (9CS-17-01) From where was the sample collectedManufacturer
First name of sampler or witnessed bySubramony Last name of sampler or witnessed byKrishnamoorthy
Title of samplerCALTRANS METS QA INSPECTOR Telephone number of sampler9512014921
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameIntegrity Rebar Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL88-17-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)65033318 Head Manufacturer Lot Number(s)A213737
Rebar Size#8 Headed Bar Model Name08BNX 5P1
Size of HeadFull Size - 9x Head Connection TypeCrimped Head
Head ShapeCircular Rebar ManufacturerCMC Rebar
Head ManufacturerIntegrity Rebar Head FabricatorBarsplice BNX Buttonheads
Material Standard CodeASTM A706 Headed Bar 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