Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2022-12-18-2

Project Information

Project IdentifiersProject ID: 215677
DEA: 044G0804
EFIS: 0412000332
COOP: 042676
DIST-CO-RTE-PM04-SOL-80-R10.4/30.2
Award Date01/18/2022
Closeout DateNot set
Work DescriptionHighway widening, overhead signs, and electronic toll system.
Location DescriptionIn 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 Level1 (Verified on 04/11/2022)

Sample Information

Sample Taken Date12/18/2022 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 sampleD14 Lenton Couplers
The quantity of what the sample constitutes28 couplers From where was the sample collectedSource
First name of sampler or witnessed byKevin Last name of sampler or witnessed byCarpenter
Title of samplerQA Telephone number of sampler4156081742
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCMC Rebar Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormB24-050-22 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingAuthorization Testing
Service or UltimateUltimate Material Standard CodeASTM A615
Material Grade60 Rebar ManufacturerCMC
Coupler ManufacturerErico Intermediate Assembler or FabricatorCMC
Rebar Size#10 Coupler ModelD14
Coating StandardsUncoated Shape of RebarStraight
Rebar Hoop Diameter Rebar Hoop Fabricator
Coupler Component Heat/Lot Number(s)9892 Rebar Heat Number(s)4122279
Rebar Size 2 10 Coupler Unique IDTF-17-02

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