*Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Sample Record for 2017-06-23-8


Project Information

Project ID: 208945 DEA: 07288604 EFIS: 0700021080 COOP: 074663 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-710-6.0-9.4
Work Description: Gerald Desmond Bridge Replacement - A Design Build project. IQA samples will be selected by Port/Caltrans representatives and sent to Translab for testing.
Location Description: Port of Long Beach (District 7)
Contractor Name: Shimmick/FCC/Impregilo (SFI) JV Contractor Address: 11 Golden Shore, Suite 330
Resident Engineer: Structure Rep.: ,

Sample Information

DIME Sample ID: 2017-06-23-8
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Los Angeles Field Laboratory
Sample Organization Contact: (858) 285-5797
Type of Sample: Independent Assurance
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 06/23/2017
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 29937 lbs
A brief description of the sample: A934 Purple Epoxy Coated Rebar
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

Rebar Heat Number(s): 046517, 4064677, 4063145, 4064806
Rebar Epoxy Batch Number(s): 3529561
Rebar Coating Specification: ASTM A934
Rebar Size (#): 5, 9, 10, 11
Rebar Coating Color: Purple
Rebar Manufacturer: CMC Rebar
Rebar Coater: Fletcher Coating Company
Rebar Powder Manufacturer: Axalta
Release Number:
Quality Assurance Code: