Sample Record
Owner Lab
- G3 Quality, Incorporated - Cerritos
DIME Sample ID 2023-01-04-8
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Project Information
| Project Identifiers | Project ID: 212112 DEA: 080C2514 EFIS: 0816000076 COOP: 081645 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-10-0.0/13.2 |
| Award Date | 06/06/2018 |
| Closeout Date | Not set |
| Work Description | Design-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes |
| Location Description | LA/SBD County Line to PM 13.2 near I-15 |
| QA Service Level | 1 (Verified on 10/16/2019) |
Sample Information
| Sample Taken Date | 01/04/2023 | Sample Unique Key | 8 |
|---|---|---|---|
| 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 | 01/11/2023 |
| Sample type | Per Request | A brief description of the sample | #6 ScrewLok Type 2 Coupler |
| The quantity of what the sample constitutes | 14 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Nestor | Last name of sampler or witnessed by | Alvarez |
| Title of sampler | Inspector | Telephone number of sampler | (909) 649-7610 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | CMC Rebar | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Mountain Abut Wing Wall |
Material Information
| Material Type | SMTL TM5 - Couplers | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Service or Ultimate | Service | Material Standard Code | ASTM A706 |
| Material Grade | 60 | Rebar Manufacturer | CMC Rebar |
| Coupler Manufacturer | BarSplice | Intermediate Assembler or Fabricator | |
| Rebar Size | #6 | Coupler Model | Screwlok Type 2 |
| Coating Standards | Uncoated | Shape of Rebar | Straight |
| Rebar Hoop Diameter | Rebar Hoop Fabricator | ||
| Coupler Component Heat/Lot Number(s) | A216421 | Rebar Heat Number(s) | 4123771 |
| Rebar Size 2 | Coupler Unique ID | SF-17-03 |
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. | |||