Sample Record for 2024-10-01-26
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000259 DEA: 050N74V4 EFIS: 0522000043
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-9.2/9.7
Work Description:
Location Description: FOR CONSTRUCTION ON STATE HIGHWAY IN SANTA BARBARA COUNTY AT MONTECITO FROM 0.2 MILE NORTH OF SHEFFIELD DRIVE UNDERCROSSING TO 0.3 MILE SOUTH OF SAN YSIDRO ROAD OVERCROSSING
Contractor Name: Granite Construction Company
Contractor Address: P.O. Box 6744, Santa Barbara, CA 93160
Resident Engineer: Taylor Merlo Structure Rep.: Emiliano Berntsen
Sample Information
DIME Sample ID: 2024-10-01-26
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (530) 329-6527
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 10/01/2024
Date that the sample was received by the laboratory/organization performing the testing: 10/02/2024
The quantity of what the sample constitutes: NA
A brief description of the sample: Coupler
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Job Site
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: CMC
Coupler Manufacturer: Erico
Intermediate Assembler or Fabricator:
Rebar Size: #4
Coupler Model: Lenton Form savor
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): M0182
Rebar Heat Number(s): 4142733, 4142683
Rebar Size 2 :
Coupler Unique ID: ST-17-05
Test Results
