Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000970 DEA: 031J6304 EFIS: 0321000023
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-99-6.04/7.06
Work Description: WILLOW SLOUGH REPLACEMENT
Location Description: SACRAMENTO COUNTY NEAR ELK GROVE FROM 0.2 MILE NORTH OF ARNO ROAD TO 0.4 MILE SOUTH OF DILLARD ROAD
Contractor Name: GRANITE CONSTRUCTION
Contractor Address: 4001 BRADSHAW ROAD, SACRAMENTO, CA 95827
Resident Engineer: Chris McDermott Structure Rep.: Nhut (Jim) Ngo
DIME Sample ID: 2026-04-21-44
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: 04/21/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/21/2026
The quantity of what the sample constitutes: 7 Packs
A brief description of the sample: 0.6" 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):
Number of Coils:
Group Number:
Strand Diameter:
Grade: 270
Strand Specification: ASTM A 416
Heat Number(s): S1934567, S0518026
Mfg. Lot Number(s): S381164-2, S-381165-8
Manufacturer(s): Sumiden Wire
