Sample Record
Owner Lab
- CT METS QASI - Los Angeles Design Build Field Laboratory
DIME Sample ID 2023-05-04-1
Project Information
Project Identifiers | Project ID: 214355 DEA: 120K0214 EFIS: 1214000096 |
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DIST-CO-RTE-PM | 12-ORA-5-12.4/14.5 |
Award Date | 12/20/2019 |
Closeout Date | Not set |
Work Description | South County Improvement Project (Phase 1 - Avery/Crown Valley) PLACE HMA, INSTALL CONC PAVEMENT, RETAIN WALL, MODIFY ELECT SYS. | Add one lane btwn 73 & Oso PKWY |
Location Description | ORANGE COUNTY IN SAN JUAN CAPISTRANO, LAGUNA HILLS, LAGUNA NIGUEL AND MISSION VIEJO FROM 0.5 MILE SOUTH OF AVERY PARKWAY UNDERCROSSING TO 0.8 MILE NORTH OF CROWN VALLEY PARKWAY OVERCROSSING |
QA Service Level | 1 (Verified on 10/31/2019) |
Sample Information
Sample Taken Date | 05/04/2023 | Sample Unique Key | 1 |
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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 | 05/04/2023 |
Sample type | Quality Assurance | A brief description of the sample | #11 HRC 500/510 Couplers (LOT 1) |
The quantity of what the sample constitutes | 64 couplers | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Eric | Last name of sampler or witnessed by | Tsang |
Title of sampler | ASR | Telephone number of sampler | 9166395892 |
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | Integrity Rebar Placers | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | 55-1111 | |
Structure name | Avery Parkway Bridge Deck |
Material Information
Material Type | SMTL TM5 - Couplers | Production or Authorization Testing | Production Testing |
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Service or Ultimate | Service | Material Standard Code | ASTM A706 |
Material Grade | 60 | Rebar Manufacturer | Vinton Steel |
Coupler Manufacturer | HRC | Intermediate Assembler or Fabricator | |
Rebar Size | #11 | Coupler Model | HRC 500/510 |
Coating Standards | Uncoated | Shape of Rebar | Straight |
Rebar Hoop Diameter | Rebar Hoop Fabricator | ||
Coupler Component Heat/Lot Number(s) | HRC500 166491 HRC510 73126937 | Rebar Heat Number(s) | 2220540 |
Rebar Size 2 | Coupler Unique ID | TP-17-03 |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2023-05-04-1-1 CTM 670-December 2013 (Verified)
DIME Test ID: 2023-05-04-1-2 CTM 670-December 2013 (Verified)
DIME Test ID: 2023-05-04-1-3 CTM 670-December 2013 (Verified)