Sample Record for 2017-06-30-1
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 210735 DEA: 071193U4 EFIS: 0713000007
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-10-37.2/42.4
Work Description: CONSTRUCT HOV LANES, WIDEN BRIDGES, AND REALIGN RAMPS.
Location Description: IN LA COUNTY FROM CITRUS STREET IN WEST COVINA TO ROUTE 57 IN POMONA
Contractor Name: Guy F. Atkinson
Contractor Address: 18201 Von Karman Ave, Suite #800, IRVINE CA 92612
Resident Engineer: Rodolfo Cao Structure Rep.: David Win
Sample Information
DIME Sample ID: 2017-06-30-1
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Threaded Bar
Sample Taken Date: 06/30/2017
Date that the sample was received by the laboratory/organization performing the testing: 07/03/2017
The quantity of what the sample constitutes: 2 bars and 2 Hex nuts
A brief description of the sample: A615gr75 threadbar
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: DSI
Material Information
Production or Authorization Testing: Production Testing
Threaded Bar Specification: ASTM A615
Threaded Bar Grade: 75
Threaded Bar Type:
Rebar Size: 10
Nut Specification for Threaded Bar: A519
System Manufacturer: unknown
Epoxy Coating Color: NA
Threaded Bar Application: Soil Nail
Coating Standards: Uncoated
Bar Heat Number(s): Unknown
Nut Heat Number(s): Unknown
Bar Lot Number: Unknown
Nut Lot Number: Unknown
Coupler Heat Number(s): Unknown
Coupler Grade: Unknown
Test Results
