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Sample Record for 2017-07-25-2

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

Project Information

Project ID: 211616 DEA: 050G0404 EFIS: 0500020020 QA Service Level: 1
DIST-CO-RTE-PM: 05-SLO,MON-101-63.2/R69.3,R0.0/R1.9
Work Description: ROADWAY REHABILITATION AND BRIDGE CONSTRUCTION.
Location Description: SAN LUIS OBISPO AND MONTERY COUNTIES NEAR PASO ROBLES FROM 0.5 MILE SOUTH OF SAN MARCOS CREEK BRIDGE TO 0.2 MILE SOUTH OF BRADLEY ROAD OVERCROSSING
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 9050 NORRIS AVENUE, SUN VALLEY, CA 91352
Resident Engineer: Andrew Borrelli Structure Rep.: Garret Hilton

Sample Information

DIME Sample ID: 2017-07-25-2
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT - Unassigned/General Field Laboratory
Sample Organization Contact: (510) 385-8178
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 07/25/2017
Date that the sample was received by the laboratory/organization performing the testing: 07/25/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: Headed Rebar
From where was the sample collected: Source
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: HRC

Material Information

Production or Authorization Testing: Production Testing
Rebar Heat Number(s): xxx
Head Manufacturer Lot Number(s): xx
Rebar Size: #8 / 25mm
Headed Bar Model Name: xxx
Size of Head: Full Size - 9x
Head Connection Type: Friction Weld
Head Shape: Square
Rebar Manufacturer: xx
Head Manufacturer: xxx
Head Fabricator: xx
Material Standard Code: ASTM A706

Test Results

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.