Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2022-07-15-2

Project Information

Project IdentifiersProject ID: 215188
DEA: 080F5434
EFIS: 0817000239
Permit Numbers: 0823NMC0369
DIST-CO-RTE-PM08-RIV-I-15,SR-91-6.1-7.6
Award Date03/11/2020
Closeout DateNot set
Work DescriptionI-15 ELC: 15/91 Express Lanes Connector Project (ELC)
Location DescriptionJunction of I-15 and SR-91 in Corona, CA
QA Service Level1 (Verified on 09/16/2020)

Sample Information

Sample Taken Date07/15/2022 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 testingNot set
Sample typeQuality Assurance A brief description of the sampleHRC 120 T-Heads
The quantity of what the sample constitutes306 pcs From where was the sample collectedSource
First name of sampler or witnessed byJoaquin Last name of sampler or witnessed byMoreno
Title of samplerQuality Assurance Inspector Telephone number of sampler7146990897
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHeaded Reinforcement Corp, Fountain Valley, CA Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL161-048-22 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)4115528 Head Manufacturer Lot Number(s)Lot 1-5
Rebar Size#10 Headed Bar Model NameHRC 120
Size of HeadFull Size - 9x Head Connection TypeFriction Weld
Head ShapeSquare Rebar ManufacturerCMC Steel Arizona
Head ManufacturerWilton Head FabricatorHeaded Reinforcement Corp
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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Sample File Attachments

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Test File Attachments