Sample Record for 2017-08-02-1
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 211848 DEA: 112T2174 EFIS: 1116000131
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-5-R37.4 - R46.5
Work Description: (Alternative Delivery) CMGC, San Elijo Highway Bridge Replacement. Replace the San Elijo lagoon highway bridge, construct HOV lanes, construct bike and pedestrian trails and bridge, build multi-use facility at Manchester Ave.
Location Description: IN SAN DIEGO COUNTY IN SOLANA BEACH AND ENCINITAS FROM 0.1 MILE NORTH OF LOMAS SANTA FE DRIVE OVERCROSSING TO 0.2 MILE SOUTH OF BIRMINGHAM DRIVE OVERCROSSING
Contractor Name: Flatiron-Skanska-Stacy and Witbeck, a Joint Venture
Contractor Address: 1770 La Costa Meadows Drive, San Marcos, CA 92078
Resident Engineer: Steve McMillan Structure Rep.: Phong Le
Sample Information
DIME Sample ID: 2017-08-02-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 08/02/2017
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 1601 lbs
A brief description of the sample: A775 Expoxy Coated rebar
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Western Coating
Material Information
Rebar Heat Number(s): TBD
Rebar Epoxy Batch Number(s):
Rebar Coating Specification: ASTM A775
Rebar Size (#): #4
Rebar Coating Color: Purple
Rebar Manufacturer: Unknown
Rebar Coater: Western Coating
Rebar Powder Manufacturer: Unknown
Release Number:
Quality Assurance Code:
Test Results
