Sample Record for 2025-06-13-1
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 995254 DEA: 040P9204 EFIS: 0418000026
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-680-6.4/6.6
Work Description: HMA AND RHMA SURFACING, DECK REPAIR, POLYESTER OVERLAY AND JOIN SEALS
Location Description: ALAMEDA COUNTY IN FREMONT FROM 0.1 MILE SOUTH OF MISSION SAN JOSE 680/238 SEPARATION TO 0.3 MILE NORTH OF MISSION SAN JOSE 680/238 SEPARATION
Contractor Name: MYERS & SONS CONSTRUCTION, LLC.
Contractor Address: 45 Morrison Avenue, Sacramento, CA 95838
Resident Engineer: Scott Sowko Structure Rep.: Jordan Jarosz
Sample Information
DIME Sample ID: 2025-06-13-1
TL Number from the TL Form:
Sample Submitted By Organization: CT SC - 3674 - Livermore
Sample Organization Contact: (510) 393-1493
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 06/13/2025
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 50 lbs
A brief description of the sample: Lenton form savers
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 A615
Material Grade: 60
Rebar Manufacturer: Martinez Steel
Coupler Manufacturer: Erico
Intermediate Assembler or Fabricator:
Rebar Size: #5
Coupler Model: Lenton
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): 245456
Rebar Heat Number(s): 450224
Rebar Size 2 :
Coupler Unique ID: ST-17-05
Test Results
