Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2023-07-31-5
Sample Details QR Code
Scan this code to open this Sample Details view on another device.
Project Information
| Project Identifiers | Project ID: 214998 DEA: 044H0504 EFIS: 0413000080 |
|---|---|
| DIST-CO-RTE-PM | 04-SON-12-25.8-33.3 |
| Award Date | 07/29/2022 |
| Closeout Date | Not set |
| Work Description | BRIDGE SCOUR MITIGATION |
| Location Description | SONOMA COUNTY NEAR SANTA ROSA AT SONOMA CREEK BRIDGE AND AT HOOKER CREEK BRIDGE |
| QA Service Level | 1 (Verified on 09/10/2020) |
Sample Information
| Sample Taken Date | 07/31/2023 | Sample Unique Key | 5 |
|---|---|---|---|
| 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 | 08/03/2023 |
| Sample type | Quality Assurance | A brief description of the sample | A722 Threaded Bar |
| The quantity of what the sample constitutes | 2 sets | From where was the sample collected | Supplier |
| First name of sampler or witnessed by | Subramony | Last name of sampler or witnessed by | Krishnamoorthy |
| Title of sampler | Quality Assurance Inspector | Telephone number of sampler | 951-201-4921 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | William Form Engineering | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L88-006-23 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM5 - Threaded Bar | Production or Authorization Testing | Production Testing |
|---|---|---|---|
| Threaded Bar Specification | ASTM A722 | Threaded Bar Grade | 150 |
| Threaded Bar Type | Plain | Rebar Size | |
| Nut Specification for Threaded Bar | ASTM A29/A108 | System Manufacturer | William Form |
| Epoxy Coating Color | NA | Threaded Bar Application | Threaded Bar |
| Coating Standards | Uncoated | Bar Heat Number(s) | 58052332 |
| Nut Heat Number(s) | 75084199 | Bar Lot Number | 5WF06M |
| Nut Lot Number | 36E9D | Coupler Heat Number(s) | |
| Coupler Grade |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2023-07-31-5-1 ASTM A722-18 (Verified)
DIME Test ID: 2023-07-31-5-2 ASTM A722-18 (Verified)