Sample Record for 2022-08-16-11
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 993771 DEA: 07325204 EFIS: 0716000082
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-210-R36.7/R37.1
Work Description: San Gabriel River Bridge - CM/GC Project - Hinge And Diaphragm Repairs
Location Description: Los Angeles County - LOS ANGELES COUNTY IN IRWINDALE FROM 0.2 MILE EAST OF 0.7 MILE WEST OF IRWINDALE AVENUE OVECROSSING
Contractor Name: FLATIRON WEST INC
Contractor Address: 14726 Ramona Avenue, Suite 300, Chino, CA 91710
Resident Engineer: Moe Izadpanah Structure Rep.: Quynh Nguyen
Sample Information
DIME Sample ID: 2022-08-16-11
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: 08/16/2022
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 8 Headed bars from lots 1-2
A brief description of the sample: #11 HRC 555 Headed Bars
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Steel Group
Material Information
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 1201041289
Head Manufacturer Lot Number(s): Lots 1-2
Rebar Size: #11
Headed Bar Model Name: HRC 555 Round Headed Bars
Size of Head: Full Size - 9x
Head Connection Type: Forged
Head Shape: Circular
Rebar Manufacturer: Nucor
Head Manufacturer: HRC Pacific Steel Group
Head Fabricator: Pacific Steel Group
Material Standard Code: ASTM A706
Headed Bar Unique ID:
Test Results
