Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2022-04-20-2
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215255 DEA: 040A7714 EFIS: 0420000287 |
|---|---|
| DIST-CO-RTE-PM | 04-ALA-80-6.4-6.6 |
| Award Date | 05/03/2021 |
| Closeout Date | 12/01/2023 |
| Work Description | CONSTRUCT PEDESTRIAN OVERCROSSING BRIDGE AND RETAINING WALLS. GILMAN INTERCHANGE IMPROVEMENTS |
| Location Description | ALAMEDA COUNTY IN BERKELEY FROM 0.6 MILE NORTH OF UNIVERSITY AVENUE OVERCROSSING TO 0.1 MILE SOUTH OF GILMAN STREET UNDERCROSSING |
| QA Service Level | 1 (Verified on 12/07/2020) |
Sample Information
| Sample Taken Date | 04/20/2022 | Sample Unique Key | 2 |
|---|---|---|---|
| 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 testing | 04/20/2022 |
| Sample type | Quality Control | A brief description of the sample | #14 HRC 220 T-heads |
| The quantity of what the sample constitutes | 8 Samples from lot 1-2 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Osiel | Last name of sampler or witnessed by | Ramirez |
| Title of sampler | Quality Assurance Inspector | Telephone number of sampler | 5599740870 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Headed Reinforcement Corp | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L123-026-22 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM5 - Headed Bars | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Rebar Heat Number(s) | 3101012 and 3108742 | Head Manufacturer Lot Number(s) | Lot 1 and 2 |
| Rebar Size | #14 | Headed Bar Model Name | HRC 220 |
| Size of Head | Full Size - 9x | Head Connection Type | Friction Weld |
| Head Shape | Circular | Rebar Manufacturer | CMC Texas and CMC California |
| Head Manufacturer | HRC | Head Fabricator | HRC Fountain Valley |
| Material Standard Code | ASTM A706 | Headed Bar Unique ID | Not set |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||