Sample Record for 2023-12-08-7
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 993446 DEA: 120J34U4 EFIS: 1218000034
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-55,55-29.6,R6.4/10.3
Work Description: CONSTR BRIDGES, RW, SW, JPCP, HMA PVMT, DRAINAGE AND ELECT SYSTEMS.
Location Description: ORANGE COUNTY IN IRVINE, SANTA ANA, AND TUSTIN ON ROUTE 5 AT NEWPORT AVENUE UNDERCROSSING AND ON ROUTE 55 FROM 0.4 MILE NORTH OF ROUTE 55/405 SEPARATION TO 0.1 MILE SOUTH OF ROUTE 5/55 SEPARATION
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 Townsgate Road, Suite 200, Westlake Village, CA 91361
Resident Engineer: Adrian Wu Structure Rep.: Yong Gyun Park
Sample Information
DIME Sample ID: 2023-12-08-7
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: Authorization
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 12/08/2023
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 8 Grip-Twist Couplers
A brief description of the sample: #6 Rebar Grip-Twist Couplers
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Security Paving ? Integrity Rebar
Material Information
Production or Authorization Testing: Authorization Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Cascade Steel
Coupler Manufacturer: BarSplice
Intermediate Assembler or Fabricator:
Rebar Size: #6
Coupler Model: Taper Threaded Grip- Twist
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): A186986,A193034,A210678,A202267
Rebar Heat Number(s): 425722
Rebar Size 2 :
Coupler Unique ID: SS-17-03
Test Results
