Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995493 DEA: 081G6704 EFIS: 0816000049
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-79-5.4/11.4
Work Description: HOT MIX ASPHALT, SOIL NAIL, STRUCTURAL CONCRETE AND ROADWAY EXC.
Location Description: RIVERSIDE COUNTY NEAR TEMECULA FROM 0.4 MILE SOUTH OF SAGE ROAD TO 1.1 MILES SOUTH OF PAUBA ROAD
Contractor Name: ORTIZ ENTERPRISES, INC.
Contractor Address: 6 CUSHING STE 200, IRVINE, CA 92618
Resident Engineer: Osama Abdalla Structure Rep.: Arnel Vega
DIME Sample ID: 2025-09-15-18
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 TM4 - Prestressing Strand
Sample Taken Date: 09/15/2025
Date that the sample was received by the laboratory/organization performing the testing: 09/15/2025
The quantity of what the sample constitutes: 500 ft
A brief description of the sample: ASTM A416 seven wire uncoated steel strand
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: RKR Steel Welding
Comments:
Reel/Coil/Pack Number(s):
Number of Coils:
Group Number:
Strand Diameter: .5 in
Grade: 250
Strand Specification: ASTM A 416
Heat Number(s): 05650
Mfg. Lot Number(s): 21554
Manufacturer(s): Sumiden Wire Insteel
