Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2022-08-19-2
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215188 DEA: 080F5434 EFIS: 0817000239 Permit Numbers: 0823NMC0369 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-I-15,SR-91-6.1-7.6 |
| Award Date | 03/11/2020 |
| Closeout Date | Not set |
| Work Description | I-15 ELC: 15/91 Express Lanes Connector Project (ELC) |
| Location Description | Junction of I-15 and SR-91 in Corona, CA |
| QA Service Level | 1 (Verified on 09/16/2020) |
Sample Information
| Sample Taken Date | 08/19/2022 | 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 | Not set |
| Sample type | Quality Control | A brief description of the sample | #11 HRC 120-T Heads |
| The quantity of what the sample constitutes | 1 lot of 80 ea. | 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 | Source Inspector | Telephone number of sampler | (562) 360-5216 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | HRC Fountain Valley | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L123-090-22 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM5 - Headed Bars | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Rebar Heat Number(s) | 4118966 | Head Manufacturer Lot Number(s) | 10021186520 |
| Rebar Size | #11 | Headed Bar Model Name | HRC 120 T Heads |
| Size of Head | Full Size - 9x | Head Connection Type | Friction Weld |
| Head Shape | Square | Rebar Manufacturer | CMC Steel Arizona |
| Head Manufacturer | HRC Fountain Valley | 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. | |||