Sample Record

Owner Labs

  • Sequoia Consultants
  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2023-01-10-4

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 Date06/05/2024
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 Date01/10/2023 Sample Unique Key4
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 Control A brief description of the sample#10 HRC 120
The quantity of what the sample constitutes270 From where was the sample collectedFabricator
First name of sampler or witnessed bySteve Last name of sampler or witnessed byHall
Title of samplerCT METS QA INSPECTOR Telephone number of sampler949-350-3970
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHRC Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL134-003-23 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)4124080 Head Manufacturer Lot Number(s)1 and 2
Rebar Size#10 Headed Bar Model NameHRC 120
Size of HeadFull Size - 9x Head Connection TypeFriction Weld
Head ShapeSquare Rebar ManufacturerCMC Steel Arizona
Head ManufacturerHRC Fountain Valley Head FabricatorHRC Fountain Valley
Material Standard CodeASTM A706 Headed Bar Unique ID9FW-17-03

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Test File Attachments