Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994506 DEA: 061F7204 EFIS: 0623000158
QA Service Level: 1
DIST-CO-RTE-PM: 06-TUL-198-14.65, 14.65/14.65
Work Description:
Location Description:
Contractor Name: MCM Construction, Inc.
Contractor Address: 6413 32nd Street, North Highlands, Ca 95660
Resident Engineer: Haidar Haddadin Structure Rep.: Ramandeep Guraya
DIME Sample ID: 2023-05-15-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Verification
Type of Material: SMTL TM6 - Steel Check Sample Plate
Sample Taken Date: 05/15/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/26/2023
The quantity of what the sample constitutes: 1
A brief description of the sample: Bottom Flange of Girder
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: Farmersville Road High Load Hit
The fabricator/manufacturer/facility name: Field
DIME Test ID: 2023-05-15-1-1
Test Method: ASTM A370-20: Standard Test Methods and Definitions for Mechanical Testing of Steel Products (Tensile - Round Sample)
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
Data has not been verified.
