Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 88888 DEA: SMTL-STOCK EFIS: SMTL-STOCK
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for SMTL stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2023-04-18-7
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: Stock
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 04/18/2023
Date that the sample was received by the laboratory/organization performing the testing: 04/21/2023
The quantity of what the sample constitutes: 2250
A brief description of the sample: 1-1/4-7 Hex Nut GAL
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue Circle
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: N/A
Coupler Manufacturer: Unytite Inc
Intermediate Assembler or Fabricator:
Rebar Size: #3
Coupler Model: Galvanized Hex Nut
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): 20837470
Rebar Heat Number(s): 20837470
Rebar Size 2 :
Coupler Unique ID: Not on AML
