Sample Record for 2022-07-13-6
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214522 DEA: 07291304 EFIS: 0712000083
QA Service Level: 1
DIST-CO-RTE-PM: 07-VEN-33-7.6
Work Description: INSTALL STRUCTURAL CONCRETE, CIDH AND BRIDGE REMOVAL.
Location Description: VENTURA COUNTY AT SAN ANTONIO CREEK BRIDGE
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 Townsgate Road, Suite 200, Westlake Village, CA 91361
Resident Engineer: Saeid Shakeri Structure Rep.: Aziz Maghsoudloo
Sample Information
DIME Sample ID: 2022-07-13-6
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: 07/13/2022
Date that the sample was received by the laboratory/organization performing the testing: 07/20/2022
The quantity of what the sample constitutes: 150
A brief description of the sample: #11 BarSplice Griptwist
From where was the sample collected: Other
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Next Century Rebar
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Vinton Steel
Coupler Manufacturer: BarSlice
Intermediate Assembler or Fabricator:
Rebar Size: #11
Coupler Model: Barsplice Taper Grip-Twist
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): A215450, A213740
Rebar Heat Number(s): 1910271
Rebar Size 2 : 11
Coupler Unique ID:
Test Results
