Sample Record for 2025-07-18-14
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 993678 DEA: 042Q8004 EFIS: 0419000050 COOP: 042836,042944
QA Service Level: 1
DIST-CO-RTE-PM: 04-SM-101,92-US 101 & SR 92-10.9/12.1 & 11.8/13.4
Work Description: US 101/SR 92 INTERCHANGE AREA IMPROVEMENT :PROJECT WILL CONSTRUCT CONGESTION RELIEF IMPROVEMENTS AT THE US 101/SR 92 INTERCHANGE AREA.
Location Description:
Contractor Name: GORDON N. BALL, INC.
Contractor Address: 333 CAMILLE AVENUE, ALAMO, CA 94507
Resident Engineer: Mohamed Fouad Structure Rep.: Bryan Nagid
Sample Information
DIME Sample ID: 2025-07-18-14
TL Number from the TL Form: C982406
Sample Submitted By Organization: CT SC - 3674 - Pacifica 2
Sample Organization Contact: (510) 714-7639
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 07/18/2025
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 60 each
A brief description of the sample: HRC 500 510 Couplers
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Transpacific Steel
Material Information
Production or Authorization Testing: Authorization Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Nucor
Coupler Manufacturer: Headed Reinforcement Corporation
Intermediate Assembler or Fabricator:
Rebar Size: #10
Coupler Model: 500-510
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): 74137464, 58053538
Rebar Heat Number(s): 3500036077
Rebar Size 2 :
Coupler Unique ID: TF-17-01
Test Results
