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Sample Record for 2017-12-04-1

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

Project Information

Project ID: 211856 DEA: 11408604 EFIS: 1112000016 QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-8-T0.5/R0.7
Work Description: COLD PLANE AND OVERLAY WITH RHMA, GRIND PCC, MGS AND END TREATMENTS.
Location Description: SAN DIEGO COUNTY IN SAN DIEGO FROM NIMITZ BOULEVARD TO 0.2 MILE WEST OF PRESIDIO PARK OVERCROSSING
Contractor Name: HAZARD CONSTRUCTION COMPANY
Contractor Address: 6465 MARINDUSTRY DRIVE, SAN DIEGO CA 92121
Resident Engineer: Sultan Ghazialam Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2017-12-04-1
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT - Unassigned/General Field Laboratory
Sample Organization Contact: 5625005861
Type of Sample: Quality Assurance
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 12/04/2017
Date that the sample was received by the laboratory/organization performing the testing: 12/04/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: ASTM A934 Rebar
From where was the sample collected: Source
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Fletcher Coating

Material Information

Rebar Heat Number(s): xxx
Rebar Epoxy Batch Number(s): xxx
Rebar Coating Specification: ASTM A934
Rebar Size (#): #4
Rebar Coating Color: Purple
Rebar Manufacturer: Unknown
Rebar Coater: Unknown
Rebar Powder Manufacturer: Unknown
Release Number: xxxx
Quality Assurance Code: xxx

Test Results