Sample Record for 2026-04-07-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214151 DEA: 080R0104 EFIS: 0812000007
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-91-R0.3
Work Description: STR EXC, FURNISH PRECAST RCB CULVERT AND STR CONC RETAINING WALL.
Location Description: RIVERSIDE COUNTY NEAR CORONA AT 0.7 MILES WEST OF GREEN RIVER ROAD OVERCROSSING
Contractor Name: BEADOR CONSTRUCTION COMPANY, INC.
Contractor Address: 2900 Bristol Street, Suite D204, Costa Mesa, CA 92626
Resident Engineer: Mohamad Alsheikh Structure Rep.: Osama Francis
Sample Information
DIME Sample ID: 2026-04-07-2
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Quality Control
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 04/07/2026
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 16 pcs
A brief description of the sample: #9 rebar with T-head
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name: RIVERSIDE COUNTY NEAR CORONA AT 0.7 MILES WEST OF GREEN RIVER ROAD OVERCROSSING
The fabricator/manufacturer/facility name: Martinez Steel
Material Information
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 046126
Head Manufacturer Lot Number(s): Eaton 539314
Rebar Size: #9
Headed Bar Model Name: LU28DR16D
Size of Head: Reduced Size - 4x
Head Connection Type: Friction Weld
Head Shape: Circular
Rebar Manufacturer: Cascade Steel
Head Manufacturer: Erico Lenton nVent
Head Fabricator: Erico Lenton nVent
Material Standard Code: ASTM A615
Headed Bar Unique ID: 4FW-18-01
Test Results
