Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2023-10-12-4
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994245 DEA: 051H4304 EFIS: 0516000073 |
|---|---|
| DIST-CO-RTE-PM | 05-SB-101-21.4/21.9 |
| Award Date | 03/02/2023 |
| Closeout Date | Not set |
| Work Description | REPLACE STRUCTURAL CONCRETE BRIDGES. |
| Location Description | SANTA BARBARA COUNTY IN GOLETA FROM ROUTE 101/217 SEPARATION TO 0.3 MILE NORTH OF SAN JOSE CREEK BRIDGE |
| QA Service Level | 1 (Verified on 09/19/2022) |
Sample Information
| Sample Taken Date | 10/12/2023 | Sample Unique Key | 4 |
|---|---|---|---|
| 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 | Not set |
| Sample type | Quality Assurance | A brief description of the sample | ALL Threaded Bar 1-1/4 |
| The quantity of what the sample constitutes | 2 Assemblies | From where was the sample collected | Distributor |
| First name of sampler or witnessed by | Lorenzo | Last name of sampler or witnessed by | Garcia |
| Title of sampler | Quality Assurance Inspector | Telephone number of sampler | 17029172503 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Williams Form Engineering-SD | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L115-103-23 | 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 | 722 |
| Threaded Bar Type | Deformed | Rebar Size | |
| Nut Specification for Threaded Bar | A29 Grade 1045 | System Manufacturer | Gerdau |
| Epoxy Coating Color | NA | Threaded Bar Application | Threaded Bar |
| Coating Standards | Uncoated | Bar Heat Number(s) | 58055773 |
| Nut Heat Number(s) | Bar Lot Number | ||
| Nut Lot Number | Coupler Heat Number(s) | C205720 | |
| Coupler Grade | A29-Gr. 1045 |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||