Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2023-08-31-1

Project Information

Project IdentifiersProject ID: 994326
DEA: 051C3604
EFIS: 0512000134
DIST-CO-RTE-PM05-SB-217-0.9/1.4
Award Date01/31/2023
Closeout DateNot set
Work DescriptionREPLACE BRIDGE.
Location DescriptionSANTA BARBARA COUNTY NEAR GOLETA FROM 0.2 MILE EAST OF GOLETA SLOUGH BRIDGE TO 0.4 MILE EAST OF SAN JOSE CREEK BRIDGE
QA Service Level1 (Verified on 10/17/2022)

Sample Information

Sample Taken Date08/31/2023 Sample Unique Key1
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 testing09/01/2023
Sample typeQuality Assurance A brief description of the sample#6 x 2'-6" dia. hoops
The quantity of what the sample constitutes1500 lots 7-16 From where was the sample collectedFabricator
First name of sampler or witnessed byOsiel Last name of sampler or witnessed byRamirez
Title of samplerCT METS QA INSPECTOR Telephone number of sampler916-767-3535
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameRKR Steel Welding Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL123-052-23 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Welded Hoops Production or Authorization TestingProduction Testing
Service or UltimateUltimate Rebar Heat Number(s)221422
Hoop Manufacturer Lot Number(s)11 and 16 Material Standard CodeASTM A706
Material Grade60 Rebar Size#6
Diameter of Hoop2'-6" Epoxy CoatedNo
Epoxy Coating ColorNA Rebar ManufacturerCascade Steel Oregon
Welding CompanyRKR Steel Welding Coating StandardsUncoated
Weld TypeFlash Welded

Submitted Tests

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