Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001955 DEA: 061H6904 EFIS: 0625000252 COOP: NONE
QA Service Level: 1
DIST-CO-RTE-PM: 06-TUL-190-42.75
Work Description: Install Sidehill Viaduct (Bridge No. 46-0285).
Location Description:
Contractor Name: CCFG Construction (Michael Niven)
Contractor Address: 17750 Wards Ferry Road, Sonora, CA 95370
Resident Engineer: Cesar Mandujano Structure Rep.: Ye Yang
DIME Sample ID: 2026-03-10-8
TL Number from the TL Form: L191-035-26
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: 03/10/2026
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 8
A brief description of the sample: #6 x 2'-6"
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC Rebar
Production or Authorization Testing: Authorization Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 4153620
Hoop Manufacturer Lot Number(s): 1 & 2
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: #8
Diameter of Hoop: 2'-6"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: CMC
Welding Company: CMC Rebar
Coating Standards: Uncoated
Weld Type: Flash Welded
