Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 213411 DEA: 030H10U4 EFIS: 0317000246
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-5-9.7/24.9
Work Description:
Location Description: Construction on state highway in Sacramento County in and near Sacramento from 1.1 miles south of Elk Grove Boulevard to American River Viaduct
Contractor Name: NOR CAL PAVING TEICHERT/GRANITE
Contractor Address: 400 Sunrise Ave. Ste. #300, Roseville, CA 95661
Resident Engineer: Daniel Tecle Structure Rep.: Pha Tran
DIME Sample ID: 2019-10-08-5
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 - Welded Hoops
Sample Taken Date: 10/08/2019
Date that the sample was received by the laboratory/organization performing the testing: 10/11/2019
The quantity of what the sample constitutes: 2 sets of 4 #8 hoops
A brief description of the sample: #8 Hoops
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: RKR Steel Welding
Production or Authorization Testing: Authorization Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 9000466
Hoop Manufacturer Lot Number(s): Lot 1 and 2
Material Standard Code: ASTM A615
Material Grade: 60
Rebar Size: 8
Diameter of Hoop: 2'-11"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: CMC Steel CA
Welding Company: RKR Steel Welding
Coating Standards: Uncoated
Weld Type: Flash Welded
