Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001640 DEA: 010N2904 EFIS: 0123000202
QA Service Level: 1
DIST-CO-RTE-PM: 01-DN-197,199-Var
Work Description: REPLACE BRIDGE, EXCAVATION, AND RETAINING WALLS.
Location Description: DEL NORTE COUNTY AT VARIOUS LOCATIONS
Contractor Name: McCullough Construction, Inc.
Contractor Address: 57 Aldergrove Rd, Arcata, CA 95521
Resident Engineer: Aaron Valley Structure Rep.: Joshua Lee
DIME Sample ID: 2026-05-05-31
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: 05/05/2026
Date that the sample was received by the laboratory/organization performing the testing: 05/06/2026
The quantity of what the sample constitutes: 1
A brief description of the sample: 6/10" 270 KSI Steel 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): s0511026
Mfg. Lot Number(s): S381156-8
Manufacturer(s): Sumiden Wire
