Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994574 DEA: 050C7334 EFIS: 0518000116
QA Service Level: 1
DIST-CO-RTE-PM: 05-SCR-1-10.5/13.4
Work Description: CONSTRUCT OVERCROSSING AND AUXILIARY LANE/ Replace Capitola Ave OC + RWs and SWs
Location Description: SANTA CRUZ COUNTY IN AND NEAR CITY OF CAPITOLA FROM STATE PARK DRIVE OVERCROSSING TO 0.2 MILE NORTH OF BAY AVENUE UNDERCROSSING
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 580 West Beach Street, Watsonville, CA 95076
Resident Engineer: Fernando Dos Santos Structure Rep.: Daniel Dait
DIME Sample ID: 2025-07-23-3
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 Control
Type of Material: SMTL TM5 - Welded Hoops
Sample Taken Date: 07/23/2025
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 44
A brief description of the sample: ASTM A706 #6 2'0" diameter Ultimate Splice Hoops
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: TNT Rebar
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 095224
Hoop Manufacturer Lot Number(s): Lot no. 1
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
Welding Company: TNT Rebar Company
Coating Standards: Uncoated
Weld Type: Flash Welded
