Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2022-04-20-2

Project Information

Project IdentifiersProject ID: 215255
DEA: 040A7714
EFIS: 0420000287
DIST-CO-RTE-PM04-ALA-80-6.4-6.6
Award Date05/03/2021
Closeout Date12/01/2023
Work DescriptionCONSTRUCT PEDESTRIAN OVERCROSSING BRIDGE AND RETAINING WALLS. GILMAN INTERCHANGE IMPROVEMENTS
Location DescriptionALAMEDA COUNTY IN BERKELEY FROM 0.6 MILE NORTH OF UNIVERSITY AVENUE OVERCROSSING TO 0.1 MILE SOUTH OF GILMAN STREET UNDERCROSSING
QA Service Level1 (Verified on 12/07/2020)

Sample Information

Sample Taken Date04/20/2022 Sample Unique Key2
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 testing04/20/2022
Sample typeQuality Control A brief description of the sample#14 HRC 220 T-heads
The quantity of what the sample constitutes8 Samples from lot 1-2 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 nameHeaded Reinforcement Corp Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL123-026-22 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)3101012 and 3108742 Head Manufacturer Lot Number(s)Lot 1 and 2
Rebar Size#14 Headed Bar Model NameHRC 220
Size of HeadFull Size - 9x Head Connection TypeFriction Weld
Head ShapeCircular Rebar ManufacturerCMC Texas and CMC California
Head ManufacturerHRC Head FabricatorHRC Fountain Valley
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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Test File Attachments