Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2022-02-23-5

Project Information

Project IdentifiersProject ID: 214337
DEA: 080E33U4
EFIS: 0817000075
DIST-CO-RTE-PM08-SBD-115-R7.3/R10.0
Award Date04/26/2021
Closeout DateNot set
Work DescriptionADD WB AUX & EB DECEL LANES, WIDEN I15 SW CONNECT,RAMPS/BRDG
Location DescriptionSAN BERNARDINO COUNTY IN ONTARIO FROM 0.2 MILE WEST OF CUCAMONGA CREEK BRIDGE TO MILLIKEN AVENUE
QA Service Level1 (Verified on 06/23/2021)

Sample Information

Sample Taken Date02/23/2022 Sample Unique Key5
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 testingNot set
Sample typeQuality Control A brief description of the sample#6 hoop 2'-6" diameter
The quantity of what the sample constitutes12 hoops from lot 1 thru 3 From where was the sample collectedFabricator
First name of sampler or witnessed byOsiel Last name of sampler or witnessed byRamirez
Title of samplerQuality Assurance Inspector Telephone number of sampler5599740870
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameRKR Steel Welding Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL123-007-22 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateUltimate Rebar Heat Number(s)1201036646
Hoop Manufacturer Lot Number(s)Lot 1 thru 3 Material Standard CodeASTM A706
Material Grade60 Rebar Size#6
Diameter of Hoop2'-6" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerNucor
Welding CompanyRKR Steel Welding Coating StandardsUncoated
Weld TypeFlash Welded

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Test File Attachments