Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2023-04-06-3

Project Information

Project IdentifiersProject ID: 993141
DEA: 060V1204
EFIS: 0616000207
DIST-CO-RTE-PM06-MAD-99-R6.9/R7.6
Award Date06/22/2022
Closeout DateNot set
Work DescriptionCottonwood Creek Bridge Replacement - REPLACE BRIDGES AND CONSTRUCT RETAINING WALLS.
Location DescriptionMADERA COUNTY NEAR MADERA FROM 0.4 MILE SOUTH OF COTTONWOOD CREEK BRIDGE TO 0.1 MILE NORTH OF AVENUE 12 OVERCROSSING
QA Service Level1 (Verified on 07/28/2021)

Sample Information

Sample Taken Date04/06/2023 Sample Unique Key3
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#6 2'-6"
The quantity of what the sample constitutes1086 From where was the sample collectedFabricator
First name of sampler or witnessed byLorenzo Last name of sampler or witnessed byGarcia
Title of samplerQuality Assurance Inspector Telephone number of sampler17029172503
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) FormL115-028-23 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateUltimate Rebar Heat Number(s)4126992
Hoop Manufacturer Lot Number(s)Lots 1 - 8 Material Standard CodeASTM A706
Material Grade60 Rebar Size#6
Diameter of Hoop2'-6" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerCMC Steel Oklahoma, Arizona
Welding CompanyCMC Rebar San Bernardino Coating StandardsUncoated
Weld TypeFlash Welded

Submitted Tests

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