Sample Record for 2025-01-21-2
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: 2025-01-21-2
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 - Couplers
Sample Taken Date: 01/21/2025
Date that the sample was received by the laboratory/organization performing the testing: 01/21/2025
The quantity of what the sample constitutes: 8
A brief description of the sample: #10 Erico Male Taper w/D14 Terminator
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Martinez Steel
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Cascade Steel
Coupler Manufacturer: Erico Lenton
Intermediate Assembler or Fabricator:
Rebar Size: #10
Coupler Model: Lenton
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): 5395930 / A234489
Rebar Heat Number(s): 056524
Rebar Size 2 : 10
Coupler Unique ID: ST-18-02
Test Results
