Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2023-05-03-23

Project Information

Project IdentifiersProject ID: 993279
DEA: 010E0904
EFIS: 0113000123
DIST-CO-RTE-PM01-MEN-20-33.3/34.4
Award Date05/06/2022
Closeout DateNot set
Work DescriptionCONSTRUCT NEW BRIDGE, REMOVE TWO BRIDGES, EARTHWORK AND PAVING. (Bridge No. 10-0310)
Location DescriptionMENDOCINO COUNTY NEAR UKIAH FROM 0.3 MILE WEST OF RUSSIAN RIVER BRIDGE AND OVERHEAD TO 0.3 MILE EAST OF COUNTY ROAD 144
QA Service Level1 (Verified on 10/04/2021)

Sample Information

Sample Taken Date05/03/2023 Sample Unique Key23
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#8 Headed rebar
The quantity of what the sample constitutes75 From where was the sample collectedFabricator
First name of sampler or witnessed byGreg Last name of sampler or witnessed byThompson
Title of samplerAssociate Steel Inspector Telephone number of sampler510-376-7155 cell
Laboratory sample identificationlot 8 Linked DIME Sample IDB9-069-23
The fabricator/manufacturer/facility nameCMC Rebar Fresno Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormB9-076-23 Structure unique identifier10-0310
Structure nameRussian River OH

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)6037518 Head Manufacturer Lot Number(s)945HT
Rebar Size#8 Headed Bar Model NameHRC 555 T Head
Size of HeadReduced Size - 4x Head Connection TypeForged
Head ShapeCircular Rebar ManufacturerCMC Rebar
Head ManufacturerCMC HRC Head FabricatorCMC HRC
Material Standard CodeASTM A706 Headed Bar Unique ID4FG-17-01

Submitted Tests

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