Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994418 DEA: 040J5504 EFIS: 0414000012
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-84-17.2/17.2
Work Description: REPLACE BRIDGE, WIDEN ROADWAY, & CONSTRUCT SIDEWALKS.
Location Description: ALAMEDA COUNTY AT SUNOL FROM SILVER SPRING ROAD UNDERPASS TO PLEASANTON SUNOL ROAD
Contractor Name: GHILOTTI CONSTRUCTION CO. INC.
Contractor Address: 246 GHILOTTI AVE., SANTA ROSA, CA 95407
Resident Engineer: Scott Sowko Structure Rep.: Jordan Jarosz
DIME Sample ID: 2026-09-30-57
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: Verification
Type of Material: SMTL TM6 - Steel Check Sample Plate
Sample Taken Date: 09/30/2026
Date that the sample was received by the laboratory/organization performing the testing: 10/07/2026
The quantity of what the sample constitutes: 40000 lbs
A brief description of the sample: 2ea 6.5' W80 S1 bars
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Nucor Rebar Fabrication Lathrop
Heat Number(s): 3500044728
Material Specification: N/A
Grade: 80
Thickness: 8
Shape: Round
Metal Foundry Manufacturer (Mill): Nucor
Plate Dimension: NA
