Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2022-07-29-2

Project Information

Project IdentifiersProject ID: 212896
DEA: 04160304
EFIS: 0400000429
DIST-CO-RTE-PM04-ALA-84-13.1/13.5
Award Date12/15/2020
Closeout DateNot set
Work DescriptionNILES CANYON ALAMEDA CREEK BRIDGE REPLACEMENT
Location DescriptionIN FREMONT, AT ALAMEDA CREEK BRIDGE (BR 33-0036).
QA Service Level1 (Verified on 09/16/2019)

Sample Information

Sample Taken Date07/29/2022 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 testing07/29/2022
Sample typeQuality Control A brief description of the sample#5 HRC 120 T-heads
The quantity of what the sample constitutes258 From where was the sample collectedManufacturer
First name of sampler or witnessed bySteve Last name of sampler or witnessed byHall
Title of samplerCT METS QA INSPECTOR Telephone number of sampler6466327821
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) FormL134-029-22 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)6032268 Head Manufacturer Lot Number(s)1, 2, 3, 4
Rebar Size#5 Headed Bar Model NameHRC120
Size of HeadFull Size - 9x Head Connection Type
Head ShapeSquare Rebar ManufacturerCMC Fontana
Head ManufacturerHRC Fountain Valley 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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Sample File Attachments

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Test File Attachments