Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2022-05-09-5
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Project Information
| Project Identifiers | Project ID: 215677 DEA: 044G0804 EFIS: 0412000332 COOP: 042676 |
|---|---|
| DIST-CO-RTE-PM | 04-SOL-80-R10.4/30.2 |
| Award Date | 01/18/2022 |
| Closeout Date | Not set |
| Work Description | Highway widening, overhead signs, and electronic toll system. |
| Location Description | In Solano County in Fairfield and Vacaville from 1.0 mile west of Red Top Road Undercrossing to 0.4 mile east of Leisure Town Road Overcrossing. |
| QA Service Level | 1 (Verified on 04/11/2022) |
Sample Information
| Sample Taken Date | 05/09/2022 | 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 | 05/25/2022 |
| Sample type | Quality Assurance | A brief description of the sample | 1-3/8" Threaded Bar Grade 150 |
| The quantity of what the sample constitutes | 7 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Lorenzo | Last name of sampler or witnessed by | Garcia |
| Title of sampler | Quality Assurance Inspector | Telephone number of sampler | 17029172503 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Williams Form | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L115-069-22 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM5 - Threaded Bar | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Threaded Bar Specification | ASTM A722 | Threaded Bar Grade | 722 |
| Threaded Bar Type | Plain | Rebar Size | |
| Nut Specification for Threaded Bar | A29-Gr. 1045 | System Manufacturer | William Form |
| Epoxy Coating Color | NA | Threaded Bar Application | Threaded Bar |
| Coating Standards | Uncoated | Bar Heat Number(s) | 100100654 |
| Nut Heat Number(s) | 75084199 | Bar Lot Number | 10010065420 |
| Nut Lot Number | 75084199 | Coupler Heat Number(s) | 212448 |
| Coupler Grade | A29-Gr. 1045 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-05-09-5-1 ASTM A722-18 (Verified)
DIME Test ID: 2022-05-09-5-2 ASTM A722-18 (Verified)