Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2022-04-22-6
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 | 04/22/2022 | Sample Unique Key | 6 |
---|---|---|---|
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 | 04/25/2022 |
Sample type | Quality Assurance | A brief description of the sample | R72 Coupler 1-3/8" |
The quantity of what the sample constitutes | 2 Couplers from 98 total | 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 | Telephone number of sampler | 5599740870 | |
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | Williams Form Engineering-SD | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | L123-031-22 | Structure unique identifier | |
Structure name |
Material Information
Material Type | SMTL TM5 - Couplers | Production or Authorization Testing | Production Testing |
---|---|---|---|
Service or Ultimate | Ultimate | Material Standard Code | ASTM A706 |
Material Grade | 60 | Rebar Manufacturer | To be provided |
Coupler Manufacturer | Williams Form Engineering | Intermediate Assembler or Fabricator | |
Rebar Size | #10 | Coupler Model | R72 Stop Type Coupling |
Coating Standards | ASTM A934 epoxy | Shape of Rebar | Straight |
Rebar Hoop Diameter | Rebar Hoop Fabricator | ||
Coupler Component Heat/Lot Number(s) | 212890 ASTM A29 | Rebar Heat Number(s) | 100100654 |
Rebar Size 2 | Coupler 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. |