Sample Record for 2018-10-24-10
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 211778 DEA: 04235654 EFIS: 0400000680
QA Service Level: 1
DIST-CO-RTE-PM: 04-SM-101,114-1.3/2.5,5.0/5.3
Work Description: RECONSTRUCT INTERCHANGE
Location Description: SAN MATEO COUNTY AT VARIOUS LOCATIONS ON ROUTE 101 FROM 0.4 MILE NORTH OF UNIVERSITY AVENUE OVERCROSSING TO 0.6 MILE SOUTH OF HENDERSON UNDERPASS AND ON ROUTE 114 FROM WILLOW ROAD SEPARATION TO NEWBRIDGE STREET
Contractor Name: Disney/OC Jones Construction Company Inc.
Contractor Address: 533 Airport Blvd, Suite 120, Burlingame, CA 94010
Resident Engineer: Fernando Abela Structure Rep.: Oanh Bui
Sample Information
DIME Sample ID: 2018-10-24-10
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Welded Hoops
Sample Taken Date: 10/24/2018
Date that the sample was received by the laboratory/organization performing the testing: 10/24/2018
The quantity of what the sample constitutes: 143
A brief description of the sample: Rebar Hoops
From where was the sample collected: Source
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC Rebar
Material Information
Production or Authorization Testing: Authorization Testing
Service or Ultimate: Service
Rebar Heat Number(s): 4073439
Hoop Manufacturer Lot Number(s): 1 and 2
Material Standard Code: ASTM A615
Material Grade: 60
Rebar Size: 7
Diameter of Hoop: 6'-2"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: CMC Rebar
Welding Company: CMC Rebar (Tracy)
Coating Standards: Uncoated
Weld Type: Flash Welded
Test Results
