Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001249 DEA: 031N5504 EFIS: 0325000797
QA Service Level: 1
DIST-CO-RTE-PM: 03-BUT-70-35/36
Work Description: Major Damage Restoration
Location Description: BUT 70 Viaduct
Contractor Name: Steelhead Constructors (Justin Babcock)
Contractor Address: 2940 INNSBRUCK DRIVE, REDDING CA 96003
Resident Engineer: Adam Scardaci Structure Rep.: Adam Scardaci
DIME Sample ID: 2025-05-23-2
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 Assurance
Type of Material: SMTL TM5 - Welded Hoops
Sample Taken Date: 05/23/2025
Date that the sample was received by the laboratory/organization performing the testing: 05/23/2025
The quantity of what the sample constitutes: 24 Hoops
A brief description of the sample: #6 bar 2'-0" dia.
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: RKR Steel Welding
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 120725
Hoop Manufacturer Lot Number(s): Lots 12 thru17
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: #6
Diameter of Hoop: 2'-0"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: Cascade Steel
Welding Company: RKR Steel Welding
Coating Standards: Uncoated
Weld Type: Flash Welded
