Sample Record for 2024-08-23-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 212720 DEA: 07291404 EFIS: 0712000094
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-1-55-58
Work Description: TRANCAS CREEK BRIDGE REPLACEMENT
Location Description: IN LOS ANGELES IN CITY OF MALIBU AT TRANCAS CREEK BRIDGE (53-0027).
Contractor Name: STACY AND WITBECK, INC.
Contractor Address: 3939 Atlantic Ave Suite 114, Long Beach, CA 90807
Resident Engineer: Dan Leon Structure Rep.: Frank Lofti
Sample Information
DIME Sample ID: 2024-08-23-2
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: 08/23/2024
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 16 Headed Bars
A brief description of the sample: #9 HRC 150 T-Heads
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: HRC- Fountain Valley
Material Information
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 9002408
Head Manufacturer Lot Number(s): 400000945421
Rebar Size: #9
Headed Bar Model Name: HRC Type 150
Size of Head: Full Size - 9x
Head Connection Type: Friction Weld
Head Shape: Circular
Rebar Manufacturer: CMC Steel Arizona
Head Manufacturer: Nucor Utah
Head Fabricator: HRC Fountian Valley
Material Standard Code: ASTM A706
Headed Bar Unique ID: 9FW-17-04
Test Results
