Sample Record for 2016-12-27-3
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 210808 DEA: 020E0904 EFIS: 0200000016
QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA-5-R29.3/R31.1,R45.0/R45.8
Work Description: REPLACE BRIDGE, REALIGN ROADWAY AND SEISMIC RETROFIT
Location Description: IN SHASTA COUNTY ABT 8 MI N OF SHASTA LAKE CTY AND NEAR LAKEHEAD FRM TURNTABLE BAY O/C TO 0.1 MI N OF O'BRIEN SRRA & FRM 0.4 MI S TO 0.3 MI N OF DOG CREEK BRIDGE.
Contractor Name: GOLDEN STATE BRIDGE, INC.
Contractor Address: 3701 Mallard Drive, Benicia, CA 94510
Resident Engineer: Nathan Alexander Structure Rep.: Christopher S 'Chris' Brace
Sample Information
DIME Sample ID: 2016-12-27-3
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Control
Type of Material: SMTL TM5 - Welded Hoops
Sample Taken Date: 12/27/2016
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 1 lot
A brief description of the sample: Ultimate Butt Splice
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Harris Rebar
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): SE16104888
Hoop Manufacturer Lot Number(s): H21
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: 8
Diameter of Hoop: 5'-8"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: Nucor
Welding Company: Harris Rebar
Coating Standards: Uncoated
Weld Type: Flash Welded
Test Results