Sample Record for 2018-10-29-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 212376 DEA: 044G8504 EFIS: 0413000052
QA Service Level: 1
DIST-CO-RTE-PM: 04-SM-1-R44.1
Work Description: REPLACE PEDESTRIAN OVERCROSSING
Location Description: SAN MATEO COUNTY IN PACIFICA AT THE SAN JOSE AVENUE PEDESTRIAN OVERCROSSING
Contractor Name: BRIDGEWAY CIVIL CONSTRUCTORS, INC.
Contractor Address: 4950 Allison Parkway, # A, Vacaville, CA 95866
Resident Engineer: Jose Mario David Structure Rep.: Jason Louie
Sample Information
DIME Sample ID: 2018-10-29-2
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Control
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 10/29/2018
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 1 lot of 10
A brief description of the sample: A706 HRC 150
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: HRC Fountain Valley
Material Information
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 6503216102
Head Manufacturer Lot Number(s): B1123978
Rebar Size: 6
Headed Bar Model Name: HRC 150
Size of Head: Reduced Size - 4x
Head Connection Type:
Head Shape: Circular
Rebar Manufacturer: Gerdau
Head Manufacturer: HRC
Head Fabricator: HRC Fountain Valley
Material Standard Code: ASTM A706
Headed Bar Unique ID:
Test Results
