Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2024-05-13-3

Project Information

Project IdentifiersProject ID: 993333
DEA: 04264724
EFIS: 0419000068
DIST-CO-RTE-PM04-MRN-101-R20.8/27.1
Award Date04/26/2022
Closeout DateNot set
Work DescriptionCIP BRIDGES, CONSTRUCT ROADWAY, RETAINING WALLS AND MODIFY ELECTRICAL.
Location DescriptionMARIN COUNTY IN AND NEAR NOVATO FROM 0.1 MILE SOUTH OF FRANKLIN AVENUE OVERHEAD TO 0.5 MILE SOUTH OF SAN ANTONIO CREEK BRIDGE
QA Service Level1 (Verified on 11/01/2021)

Sample Information

Sample Taken Date05/13/2024 Sample Unique Key3
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 Assurance A brief description of the sampleASTM A108 Grade 80 Nuts
The quantity of what the sample constitutes1000 From where was the sample collectedFabricator
First name of sampler or witnessed byArthur Last name of sampler or witnessed byPeterson
Title of samplerAssociate Steel Inspector Telephone number of sampler707-342-8602
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameNucor Skyline Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL110-069-24 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Threaded Bar Production or Authorization TestingProduction Testing
Threaded Bar SpecificationASTM A615 Threaded Bar Grade80
Threaded Bar TypeDeformed Rebar Size#8
Nut Specification for Threaded BarASTM A108 System ManufacturerNucor Skyline
Epoxy Coating ColorNA Threaded Bar ApplicationSoil Nail
Coating StandardsUncoated Bar Heat Number(s)NA
Nut Heat Number(s)5395822 Bar Lot NumberNA
Nut Lot Number6402 Coupler Heat Number(s)NA
Coupler GradeNA

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