Sample Record for 2026-10-13-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000320 DEA: 11430324 EFIS: 1118000102
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-805-14.6/23.7
Work Description: MODIFY ELECTRICAL, CONCRETE PAVEMENT, DRAINAGE AND SIGNS.
Location Description: SAN DIEGO COUNTY IN SAN DIEGO FROM ROUTE 805/15 SEPARATION TO 0.1 MILE NORTH OF ROUTE 805/52 SEPARATION
Contractor Name: COFFMAN SPECIALTIES, INC.
Contractor Address: 9685 VIA EXCELENCIA STE 200, SAN DIEGO, CA 92126
Resident Engineer: Art Pannu Structure Rep.: Jose Delgado
Sample Information
DIME Sample ID: 2026-10-13-2
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 - Couplers
Sample Taken Date: 10/13/2026
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 28 pcs
A brief description of the sample: #18 ASTM 706 zap screwlok couplers
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Legacy
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: CMC Steel Texas
Coupler Manufacturer: Bar Splice
Intermediate Assembler or Fabricator:
Rebar Size: #18
Coupler Model: Zap Screwlok SL
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): 4000037694/18SZBA C45
Rebar Heat Number(s): 3131707
Rebar Size 2 :
Coupler Unique ID: SL-21-02
Test Results
