Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2022-01-24-5
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Project Information
| Project Identifiers | Project ID: 215109 DEA: 081C8504 EFIS: 0813000047 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-74-0.0/5.8 |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | ROADWAY EXCAVATION, HOT MIX ASPHALT, AND STRUCTURAL SHOTCRETE WALLS. |
| Location Description | RIVERSIDE COUNTY NEAR LAKE ELSINORE FROM ORANGE COUNTY LINE TO MONTE VISTA STREET |
| QA Service Level | 1 (Verified on 02/24/2021) |
Sample Information
| Sample Taken Date | 01/24/2022 | Sample Unique Key | 5 |
|---|---|---|---|
| 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 testing | 02/01/2022 |
| Sample type | Quality Assurance | A brief description of the sample | ASTM A722 All-Thread-Bar (150 ksi) |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Arthur | Last name of sampler or witnessed by | Peterson |
| Title of sampler | Telephone number of sampler | 7073428602 | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Williams Form Engineering Golden, CO | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L110-008-22 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM5 - Threaded Bar | Production or Authorization Testing | Authorization Testing |
|---|---|---|---|
| Threaded Bar Specification | ASTM A722 | Threaded Bar Grade | 722 |
| Threaded Bar Type | Plain | Rebar Size | #11 |
| Nut Specification for Threaded Bar | ASTM A29 Grade 1045 | System Manufacturer | Gerdau |
| Epoxy Coating Color | Purple | Threaded Bar Application | Threaded Bar |
| Coating Standards | ASTM A934 epoxy | Bar Heat Number(s) | 5804893104 |
| Nut Heat Number(s) | 75084199 | Bar Lot Number | NA |
| Nut Lot Number | 36E9D | Coupler Heat Number(s) | NA |
| Coupler Grade | NA |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-01-24-5-1 ASTM A722-18 (Verified)
DIME Test ID: 2022-01-24-5-2 ASTM A722-18 (Verified)