Sample Record for 2018-07-03-6
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 212562 DEA: 024G5504 EFIS: 0214000036
QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-5-2.7/R11.4
Work Description: RECONSTRUCT WITH HMA AND PCC, WIDEN STRUCTURE AND UPGRADE RAILS
Location Description: SISKIYOU COUNTY IN AND NEAR DUNSMUIR FROM SACRAMENTO RIVER BRIDGE TO 0.6 MILE SOUTH OF NORTH MOUNT SHASTA UNDERPASS
Contractor Name: J.F. SHEA CONSTRUCTION
Contractor Address: P.O. BOX 494519, REDDING, CA 96049-4519
Resident Engineer: Nicole Mallory Structure Rep.: Andrew Osullivan
Sample Information
DIME Sample ID: 2018-07-03-6
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: 07/03/2018
Date that the sample was received by the laboratory/organization performing the testing: 07/03/2018
The quantity of what the sample constitutes: xxx
A brief description of the sample: A934 Purple Epoxy Coated Rebar
From where was the sample collected: Source
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: JC Supply
Material Information
Rebar Heat Number(s): xxx
Rebar Epoxy Batch Number(s):
Rebar Coating Specification: ASTM A934
Rebar Size (#): #6
Rebar Coating Color: Purple
Rebar Manufacturer: Unknown
Rebar Coater: JC Supply And Manufacturing
Rebar Powder Manufacturer: Unknown
Release Number: Unknown
Quality Assurance Code: Unknown
Test Results
