Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2024-08-15-5

Project Information

Project IdentifiersProject ID: 212720
DEA: 07291404
EFIS: 0712000094
DIST-CO-RTE-PM07-LA-1-55-58
Award Date02/18/2021
Closeout DateNot set
Work DescriptionTRANCAS CREEK BRIDGE REPLACEMENT
Location DescriptionIN LOS ANGELES IN CITY OF MALIBU AT TRANCAS CREEK BRIDGE (53-0027).
QA Service Level1 (Verified on 04/02/2021)

Sample Information

Sample Taken Date08/15/2024 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 Assurance A brief description of the sample#9 HRC 500/510 Couplers
The quantity of what the sample constitutes168 Couplers From where was the sample collectedJob Site
First name of sampler or witnessed byHenry Last name of sampler or witnessed byArredondo
Title of samplerCALTRANS QA INSPECTOR Telephone number of sampler5623329603
Laboratory sample identificationTP-17-03 Linked DIME Sample ID
The fabricator/manufacturer/facility nameHeaded Reinforcement Corp, Fountain Valley, CA Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL166-065-24 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM5 - Couplers Production or Authorization TestingAuthorization Testing
Service or UltimateUltimate Material Standard CodeASTM A706
Material Grade60 Rebar ManufacturerCMC Steel Arizona
Coupler ManufacturerHeaded Reinforcement Corporation Fountain Val Intermediate Assembler or FabricatorSalvador Lopez
Rebar Size#9 Coupler ModelHRC 500/510
Coating StandardsUncoated Shape of RebarStraight
Rebar Hoop Diameter Rebar Hoop Fabricator
Coupler Component Heat/Lot Number(s)79001741, 73131267, 79003949, 73130586 Rebar Heat Number(s)6041939, 4128942, 9001247
Rebar Size 2 Coupler Unique IDTP-17-03

Submitted Tests

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