Sample Record for 2025-03-07-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 993446 DEA: 120J34U4 EFIS: 1218000034
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-55,55-29.6,R6.4/10.3
Work Description: CONSTR BRIDGES, RW, SW, JPCP, HMA PVMT, DRAINAGE AND ELECT SYSTEMS.
Location Description: ORANGE COUNTY IN IRVINE, SANTA ANA, AND TUSTIN ON ROUTE 5 AT NEWPORT AVENUE UNDERCROSSING AND ON ROUTE 55 FROM 0.4 MILE NORTH OF ROUTE 55/405 SEPARATION TO 0.1 MILE SOUTH OF ROUTE 5/55 SEPARATION
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 Townsgate Road, Suite 200, Westlake Village, CA 91361
Resident Engineer: Adrian Wu Structure Rep.: Yong Gyun Park
Sample Information
DIME Sample ID: 2025-03-07-2
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Control
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 03/07/2025
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 20 pcs
A brief description of the sample: Lot #1 / #8 rebar HRC 120 T-heads
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: HRC
Material Information
Production or Authorization Testing: Authorization Testing
Rebar Heat Number(s): 218924
Head Manufacturer Lot Number(s): Lot 1
Rebar Size: #8
Headed Bar Model Name: 8 rebar HRC 120 T heads
Size of Head: Full Size - 9x
Head Connection Type:
Head Shape: Square
Rebar Manufacturer: Cascade Steel
Head Manufacturer: HRC Fountain Valley
Head Fabricator: Nucor Utah
Material Standard Code: ASTM A615
Headed Bar Unique ID: 9FW-17-03
Test Results
