Sample Record for 2026-06-08-5
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000707 DEA: 041Q5824 EFIS: 0421000263
QA Service Level: 1
DIST-CO-RTE-PM: 04-SM-101-0/21.8
Work Description: REHABILITATE PAVEMENT, UPGRADE SIGNS, GUARDRAIL, AND T
Location Description: SAN MATEO COUNTY FROM SAN MATEO COUNTY LINE IN EAST PALO ALTO TO 0.2 MILES NORTH OF COLMA CREEK BRIDGE IN SOUTH SAN FRANCISCO.
Contractor Name: Bay Cities Paving & Grading
Contractor Address: 1450 Civic Ct. BLDG B #400, Concord CA, 94520
Resident Engineer: Ethan Malonzo Structure Rep.: Ricardo Silva Da Costa
Sample Information
DIME Sample ID: 2026-06-08-5
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Control
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 06/08/2026
Date that the sample was received by the laboratory/organization performing the testing: 06/08/2026
The quantity of what the sample constitutes: 4
A brief description of the sample: #14 Type 220 T-heads
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: HRC - Fountain Valley
Material Information
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 3141042
Head Manufacturer Lot Number(s): 308313
Rebar Size: #14
Headed Bar Model Name: Type 220
Size of Head: Reduced Size - 4x
Head Connection Type: Friction Weld
Head Shape: Circular
Rebar Manufacturer: CMC Steel Texas
Head Manufacturer: Nucor
Head Fabricator: Nucor
Material Standard Code: ASTM A706
Headed Bar Unique ID: 9FW-17-04
Test Results
