Sample Record for 2019-09-16-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 213856 DEA: 112888U4 EFIS: 1118000199
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-11,125,905-Various
Work Description: CONSTRUCT FREEWAY TO FREEWAY CONNECTORS AND 4-LANE HIGHWAY FACILITY
Location Description: SAN DIEGO COUNTY AT VARIOUS LOCATIONS
Contractor Name: Skanska USA Civil West CA
Contractor Address: 1995 Agua Mansa Road, Riverside, CA 92509
Resident Engineer: Carlos Covarrubias Structure Rep.: Wade Durant
Sample Information
DIME Sample ID: 2019-09-16-2
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 - Welded Hoops
Sample Taken Date: 09/16/2019
Date that the sample was received by the laboratory/organization performing the testing: 09/19/2019
The quantity of what the sample constitutes: 20 for total 748
A brief description of the sample: #8 x 6'-5" Dia. Welded Hoops
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: RKR Steel Welding
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): XXXXXXXXXXXX
Hoop Manufacturer Lot Number(s): Lot 15-19
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: 8
Diameter of Hoop: 6'-5"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: CMC Steel CA
Welding Company: RKR Steel Welding
Coating Standards: Uncoated
Weld Type: Flash Welded
Test Results
