Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2024-04-24-5

Project Information

Project IdentifiersProject ID: 994574
DEA: 050C7334
EFIS: 0518000116
DIST-CO-RTE-PM05-SCR-1-10.5/13.4
Award Date06/29/2023
Closeout DateNot set
Work DescriptionCONSTRUCT OVERCROSSING AND AUXILIARY LANE.
Location DescriptionSANTA CRUZ COUNTY IN AND NEAR CITY OF CAPITOLA FROM STATE PARK DRIVE OVERCROSSING TO 0.2 MILE NORTH OF BAY AVENUE UNDERCROSSING
QA Service Level1 (Verified on 04/13/2023)

Sample Information

Sample Taken Date04/24/2024 Sample Unique Key5
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 testingNot set
Sample typeQuality Control A brief description of the sample#9 HRC 150 T-Heads
The quantity of what the sample constitutes16 Headed Bar From where was the sample collectedFabricator
First name of sampler or witnessed byArthur Last name of sampler or witnessed byPeterson
Title of samplerCT METS QA INSPECTOR Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHRC- Fountain Valley Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL110-053-24 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Headed Bars Production or Authorization TestingProduction Testing
Rebar Heat Number(s)9002025 Head Manufacturer Lot Number(s)400000369222
Rebar Size#9 Headed Bar Model NameHRC 150
Size of HeadFull Size - 9x Head Connection TypeFriction Weld
Head ShapeCircular Rebar ManufacturerCMC Steel - Rancho Cucamonga
Head ManufacturerNucor Utah Head FabricatorHRC Fountain Valley
Material Standard CodeASTM A706 Headed Bar Unique ID9FW-17-04

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