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: 2025-04-22-1
TL Number from the TL Form: TL-6034
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Verification
Type of Material: SMTL TM5 - Welded Hoops
Sample Taken Date: 04/22/2025
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 15
A brief description of the sample: Machine Qualification H&H S#H6182
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Conco Reinforcing Benicia
Production or Authorization Testing: Authorization Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 4146751
Hoop Manufacturer Lot Number(s): 1
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: #4
Diameter of Hoop: 2'-2"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: CMC Steel Arizona
Welding Company: Conco Companies Benicia
Coating Standards: Uncoated
Weld Type: Flash Welded
