Sample Record

Owner Lab

  • G3 Quality, Incorporated - Cerritos

DIME Sample ID 2021-12-02-13

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 Date12/02/2021 Sample Unique Key13
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 testing12/07/2021
Sample typePer Request A brief description of the sample#6 Dayton Superior Bar Lock
The quantity of what the sample constitutes108 From where was the sample collectedJob Site
First name of sampler or witnessed byRobert Last name of sampler or witnessed byMendoza
Title of samplerInspector Telephone number of sampler(951) 264-7798
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 nameSultana Bridge OC

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingProduction Testing
Service or UltimateService Material Standard CodeASTM A706
Material Grade60 Rebar ManufacturerCMC Rebar
Coupler ManufacturerDayton Superior Intermediate Assembler or Fabricator
Rebar Size#6 Coupler ModelBar Lock S/CA
Coating StandardsUncoated Shape of RebarStraight
Rebar Hoop Diameter Rebar Hoop Fabricator
Coupler Component Heat/Lot Number(s)4000000953 Rebar Heat Number(s)4111154
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