Sample Record for 2022-05-03-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 215677 DEA: 044G0804 EFIS: 0412000332 COOP: 042676
QA Service Level: 1
DIST-CO-RTE-PM: 04-SOL-80-R10.4/30.2
Work Description: Highway widening, overhead signs, and electronic toll system.
Location Description: In Solano County in Fairfield and Vacaville from 1.0 mile west of Red Top Road Undercrossing to 0.4 mile east of Leisure Town Road Overcrossing.
Contractor Name: O.C. JONES & SONS, INC.
Contractor Address: 1520 Fourth Street, Berkeley, CA 94710
Resident Engineer: Justen Tatum Structure Rep.: Kelsey Littell
Sample Information
DIME Sample ID: 2022-05-03-2
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 - Headed Bars
Sample Taken Date: 05/03/2022
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 30 Headed Bars
A brief description of the sample: #10 bar HRC 120 T-head
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Headed Reinforcement Corp, Fountain Valley, CA
Material Information
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 4114788
Head Manufacturer Lot Number(s): 100021479644
Rebar Size: #10
Headed Bar Model Name: HRC 120 T head
Size of Head: Full Size - 9x
Head Connection Type: Friction Weld
Head Shape: Square
Rebar Manufacturer: CMC Steel Arizona
Head Manufacturer: HRC
Head Fabricator: HRC
Material Standard Code: ASTM A706
Headed Bar Unique ID:
Test Results
