Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
DEA: No Project
QA Service Level:
DIST-CO-RTE-PM: ---
Work Description: Special project identifier for material not associated with a project
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2018-04-17-3
TL Number from the TL Form:
Sample Submitted By Organization: CT - Unassigned/General Field Laboratory
Sample Organization Contact: 5625005861
Type of Sample: Acceptance
Type of Material: SMTL TM5 - Welded Hoops
Sample Taken Date: 04/17/2018
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 15
A brief description of the sample: Resistance Butt Welded Hoops
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Harris Rebar
Production or Authorization Testing: Authorization Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): PL15104250
Hoop Manufacturer Lot Number(s): B10SP5
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: 7
Diameter of Hoop: 5'-0"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: Nucor Seattle
Welding Company: Harris Rebar
Coating Standards: Uncoated
Weld Type: Flash Welded
