Sample Record

Owner Lab

  • CT HQ - QASI Sacramento Field Office

DIME Sample ID 2023-05-24-4

Project Information

Project IdentifiersProject ID: 215741
DEA: 01366004
EFIS: 0100000127
DIST-CO-RTE-PM01-HUM-101-80.0/84.0
Award Date12/29/2022
Closeout DateNot set
Work DescriptionIndianola Cutoff UC
Location DescriptionHUMBOLDT COUNTY NEAR EUREKA FROM EUREKA SLOUGH BRIDGE TO BAYSIDE CUTOFF
QA Service Level1 (Verified on 05/17/2021)

Sample Information

Sample Taken Date05/24/2023 Sample Unique Key4
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 testing05/24/2023
Sample typeQuality Control A brief description of the sample#5 bar 1'-6.5" diameter
The quantity of what the sample constitutes150 From where was the sample collectedFabricator
First name of sampler or witnessed bySherri Last name of sampler or witnessed byBrannon
Title of samplerCT METS QA INSPECTOR Telephone number of sampler9168266371
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameConco Companies Benicia Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormB22-191-23 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingAuthorization Testing
Service or UltimateUltimate Rebar Heat Number(s) 4115946 4127485 4126773
Hoop Manufacturer Lot Number(s)1 Material Standard CodeASTM A706
Material Grade60 Rebar Size#5
Diameter of Hoop1'-6.5" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerNucor
Welding CompanyConco Companies Benicia Coating StandardsUncoated
Weld TypeFlash Welded

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