Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001941 DEA: 040V5104 EFIS: 0426000263 COOP: NONE
QA Service Level: 1
DIST-CO-RTE-PM: 04-SON--unknown
Work Description:
Location Description:
Contractor Name: Pacific Coast Drilling Co., Inc.
Contractor Address: 364 Bellevue Ave., Santa Rosa 95407
Resident Engineer: Leonard Brajnikoff Structure Rep.: nick Abuhamdieh
DIME Sample ID: 2026-04-08-28
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: 04/08/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/09/2026
The quantity of what the sample constitutes: 1 Pack
A brief description of the sample: 0.6" Prestressing Strand
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Sumiden Wire
Comments:
Reel/Coil/Pack Number(s):
Number of Coils:
Group Number:
Strand Diameter:
Grade: 270
Strand Specification: ASTM A 416
Heat Number(s): S0509826
Mfg. Lot Number(s): S337115 2
Manufacturer(s): Sumiden Wire
