Sample Record for 2024-11-25-1
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 212470 DEA: 044A1304 EFIS: 0400001106 COOP: 042718
QA Service Level: 1
DIST-CO-RTE-PM: 04-SON-101-18.5/18.5
Work Description: CONSISTS OF MODIFICATION AND RECONSTRUCTION OF THE EXISTING US 101/HEARN AVENUE INTERCHANGE IN SONOMA COUNTY, INCLUDING REPLACING THE EXISTING TWO-LANE HEARN AVENUE OVERCROSSING WITH A NEW OVERCROSSING, AND MODIFYING THE SOUTHBOUND OFF-RAMP IN CITY
Location Description: IN SONOMA COUNTY.
Contractor Name: Ghilotti Construction Company, Inc. (Chase McPhaul)
Contractor Address: 246 Ghilotti Avenue, Santa Rosa, CA 95407
Resident Engineer: Seyed "Syd" Valeh Structure Rep.: Anthony "Tony" Tierra; Sardar Chalabe
Sample Information
DIME Sample ID: 2024-11-25-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 11/25/2024
Date that the sample was received by the laboratory/organization performing the testing: 11/26/2024
The quantity of what the sample constitutes: 16 Bars
A brief description of the sample: 16 #10 Headed Bars with Lenton D14 terminators
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Martinez Steel Fresno
Material Information
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 056524
Head Manufacturer Lot Number(s): U0155, M0226
Rebar Size: #10
Headed Bar Model Name: nVent LENTON TERMINATOR D14
Size of Head: Full Size - 9x
Head Connection Type: Threaded
Head Shape: Circular
Rebar Manufacturer: Cascade
Head Manufacturer: ERICO International Corporation nVent
Head Fabricator: Martinez Steel Fresno
Material Standard Code: ASTM A706
Headed Bar Unique ID: 9FW-18-01
Test Results
