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Sample Record for 2018-01-26-1

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

Project Information

Project ID: 212731 DEA: 07318004 EFIS: 0715000280 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-10-22.3/28.2
Work Description: TREAT BRIDGE DECK, CLOSURE POUR AND REPLACE JOINT SEALS.
Location Description: LOS ANGELES COUNTY AT VARIOUS LOCATIONS FROM FREMONT AVENUE UNDERCROSSING TO RIO HONDO62
Contractor Name: SPECTRUM CONSTRUCTION GROUP, INC.
Contractor Address: 32 Edelman, Irvine, CA 92618
Resident Engineer: Moe Izadpanah Structure Rep.: Jennifer Man

Sample Information

DIME Sample ID: 2018-01-26-1
TL Number from the TL Form: C952927
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Proficiency
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 01/26/2018
Date that the sample was received by the laboratory/organization performing the testing: 01/30/2018
The quantity of what the sample constitutes: 4 test bars
A brief description of the sample: Barsplice Zap Screwlok Coupler
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: DRS Rebar Inc

Material Information

Production or Authorization Testing: Authorization Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Gerdau
Coupler Manufacturer: BarSplice
Intermediate Assembler or Fabricator: Ruben Sandoval Patrick Cromwell
Rebar Size: 5
Coupler Model: 5DBZA
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter: Unknown
Rebar Hoop Fabricator: Unknown
Coupler Component Heat/Lot Number(s): 7045
Rebar Heat Number(s): 65029565-02
Rebar Size 2 :
Coupler Unique ID:

Test Results