Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 88888 DEA: SMTL-STOCK EFIS: SMTL-STOCK
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for SMTL stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2025-03-19-10
TL Number from the TL Form:
Sample Submitted By Organization: CT - Unassigned/General Field Laboratory
Sample Organization Contact: 5625005861
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Threaded Bar
Sample Taken Date: 03/19/2025
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 30
A brief description of the sample: ASTM A307
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Rockford Bolt
Production or Authorization Testing: Production Testing
Threaded Bar Specification: ASTM A307
Threaded Bar Grade: 36
Threaded Bar Type: Plain
Rebar Size: #7
Nut Specification for Threaded Bar: na
System Manufacturer: Rockford Bolt
Epoxy Coating Color: NA
Threaded Bar Application: Threaded Bar
Coating Standards: ASTM A153 galvanized
Bar Heat Number(s): 50857
Nut Heat Number(s): na
Bar Lot Number: C3562
Nut Lot Number: na
Coupler Heat Number(s): na
Coupler Grade: na
