Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2023-03-10-3

Project Information

Project IdentifiersProject ID: 212112
DEA: 080C2514
EFIS: 0816000076
COOP: 081645
DIST-CO-RTE-PM08-SBD-10-0.0/13.2
Award Date06/06/2018
Closeout DateNot set
Work DescriptionDesign-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes
Location DescriptionLA/SBD County Line to PM 13.2 near I-15
QA Service Level1 (Verified on 10/16/2019)

Sample Information

Sample Taken Date03/10/2023 Sample Unique Key3
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing03/10/2023
Sample typeQuality Control A brief description of the sample#5 HRC 120 T-Head
The quantity of what the sample constitutes345 total #5 HRC 120 T-Heads From where was the sample collectedFabricator
First name of sampler or witnessed byHenry Last name of sampler or witnessed byArredondo
Title of samplerCaltrans QA Inspector Telephone number of sampler5623329603
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHRC Fountain Valley Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL166-023-23 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)4125896 Head Manufacturer Lot Number(s)100021624144
Rebar Size#5 Headed Bar Model NameHRC 120 T Heads
Size of HeadFull Size - 9x Head Connection TypeFriction Weld
Head ShapeSquare Rebar ManufacturerCMC Steel Arizona
Head Manufacturernucor cold finish utah 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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Sample File Attachments

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Test File Attachments