Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995202 DEA: 033H6104 EFIS: 0318000019
QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-80-42.7/49.3
Work Description: RDWY EXC, HMA, JPCP, ALT PIPELINER, STEEL SOLDIER PILE, MOD LTG SYSTEM
Location Description: PLACER COUNTY ABOUT 9.4 MILES NORTH OF COLFAX FROM 0.5 MILE WEST OF MONTE VISTA OVERCROSSING TO 0.3 MILE EAST OF DRUM FOREBAY OVERCROSSING
Contractor Name: DESILVA GATES CONSTRUCTION, LLC
Contractor Address: 11555 Dublin Blvd, Dublin, CA 94568
Resident Engineer: Tad Sampson Structure Rep.: Jimmer Ross
DIME Sample ID: 2026-03-18-28
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (213) 505-4213
Type of Sample: Quality Assurance
Type of Material: SMTL TM4 - Prestressing Strand
Sample Taken Date: 03/18/2026
Date that the sample was received by the laboratory/organization performing the testing: 03/20/2026
The quantity of what the sample constitutes: 4
A brief description of the sample: PT Strand
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Sumiden Wire
Comments:
Reel/Coil/Pack Number(s): S337090-2
Number of Coils:
Group Number:
Strand Diameter:
Grade: 270
Strand Specification: ASTM A 416
Heat Number(s): S0517126
Mfg. Lot Number(s): NA
Manufacturer(s): Sumiden Wire
