Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2024-01-30-2
Sample Details QR Code
Scan this code to open this Sample Details view on another device.
Sample is locked from editing. info
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 | 01/30/2024 | Sample Unique Key | 2 |
|---|---|---|---|
| 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 testing | 02/08/2024 |
| Sample type | Quality Assurance | A brief description of the sample | 1 1/4" 150 ksi all thread bar |
| The quantity of what the sample constitutes | 15 Threaded Bars | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Osiel | Last name of sampler or witnessed by | Ramirez |
| Title of sampler | Quality Assurance Inspector | Telephone number of sampler | (916) 767-3535 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Williams Form Engineering San Diego | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L123-004-24 | 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 | #10 |
| Nut Specification for Threaded Bar | ASTM E112 Grade 1045 | System Manufacturer | Williams Form Enginerring |
| Epoxy Coating Color | NA | Threaded Bar Application | Threaded Bar |
| Coating Standards | Uncoated | Bar Heat Number(s) | 58055774/04 |
| Nut Heat Number(s) | n/a | Bar Lot Number | Lot 1-04 |
| Nut Lot Number | n/a | Coupler Heat Number(s) | N/A |
| Coupler Grade | n/a |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2024-01-30-2-1 ASTM A722-18 (Verified)
DIME Test ID: 2024-01-30-2-2 ASTM A722-18 (Verified)