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Sample Record for 2018-11-29-2

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 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.:

Sample Information

DIME Sample ID: 2018-11-29-2
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 11/29/2018
Date that the sample was received by the laboratory/organization performing the testing: 11/29/2018
The quantity of what the sample constitutes: 4
A brief description of the sample: HRC 555 End Anchor
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC Rebar

Material Information

Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 360518
Head Manufacturer Lot Number(s): 10 / 11 / 12
Rebar Size: 4
Headed Bar Model Name: HRC 555 Enad Anchor
Size of Head: Reduced Size - 4x
Head Connection Type: Friction Weld
Head Shape: Circular
Rebar Manufacturer: Cascade
Head Manufacturer: CMC HRC
Head Fabricator: CMC Rebar
Material Standard Code: ASTM A706
Headed Bar Unique ID:

Test Results