Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 208945 DEA: 07288604 EFIS: 0700021080 COOP: 074663
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-710-6.0-9.4
Work Description: Gerald Desmond Bridge Replacement - A Design Build project. IQA samples will be selected by Port/Caltrans representatives and sent to Translab for testing.
Location Description: Port of Long Beach (District 7)
Contractor Name: Shimmick/FCC/Impregilo (SFI) JV
Contractor Address: 11 Golden Shore, Suite 330, Long Beach, CA 90802
Resident Engineer: Structure Rep.:
DIME Sample ID: 2018-05-31-6
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT - Unassigned/General Field Laboratory
Sample Organization Contact: 5625005861
Type of Sample: Independent Assurance
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 05/31/2018
Date that the sample was received by the laboratory/organization performing the testing: 06/05/2018
The quantity of what the sample constitutes: 1 lot
A brief description of the sample: Epoxy Coated Rebar
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Fletcher Coating
Rebar Heat Number(s): 4075936
Rebar Epoxy Batch Number(s): 8A25
Rebar Coating Specification: ASTM A934
Rebar Size (#): #5
Rebar Coating Color: Purple
Rebar Manufacturer: CMC
Rebar Coater: Fletcher Coating Company
Rebar Powder Manufacturer: 3M
Release Number: Unknown
Quality Assurance Code: Unknown
DIME Test ID: 2018-05-31-6-1
Test Method: ASTM A934-13: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Epoxy-Coating)
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
Data has not been verified.
DIME Test ID: 2018-05-31-6-2
Test Method: ASTM A934-13: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Holiday Bend)
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
Data has not been verified.
