Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Laboratory

DIME Sample ID 2021-12-17-2

Project Information

Project IdentifiersProject ID: 214579
DEA: 010B0904
EFIS: 0100020444
DIST-CO-RTE-PM01-DN-101-8.2/8.7
Award Date04/21/2020
Closeout DateNot set
Work DescriptionBRIDGE REPLACEMENT
Location DescriptionDEL NORTE COUNTY NEAR KLAMATH AT PANTHER CREEK BRIDGE AND AT HUNTER CREEK BRIDGE
QA Service Level1 (Verified on 03/02/2020)

Sample Information

Sample Taken Date12/17/2021 Sample Unique Key2
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 testing12/24/2021
Sample typeQuality Control A brief description of the sample#6 Headed Bar
The quantity of what the sample constitutes8 of 244 From where was the sample collectedFabricator
First name of sampler or witnessed byHitesh Last name of sampler or witnessed byPatel
Title of samplerQuality Assurance Inspector Telephone number of sampler9168691602
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHRC Fountain Valley Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL131-066-21 Structure unique identifier01-0085
Structure namePanther Creek and Hunter Creek

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)4111039 Head Manufacturer Lot Number(s)1 and 2
Rebar Size#6 Headed Bar Model NameHRC 150 Heat No 10020904124
Size of HeadFull Size - 9x Head Connection TypeFriction Weld
Head ShapeCircular Rebar ManufacturerCMC
Head ManufacturerHRC Head FabricatorHRC
Material Standard CodeASTM A706 Headed Bar Unique IDNot set

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments