Sample Record for 2019-02-07-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 213074 DEA: 044G8904 EFIS: 0413000059
QA Service Level: 1
DIST-CO-RTE-PM: 04-CC-580-5.8
Work Description: BIDGE SEISMIC RETROFIT
Location Description: CONTRA COSTA COUNTY IN RICHMOND AT SCOFIELD AVENUE UNDERCROSSING
Contractor Name: BROSAMER & WALL, INC.
Contractor Address: 1777 Oakland Blvd., Suite 300, Walnut Creek, CA 94596
Resident Engineer: Jason Trinh Structure Rep.: Eric Urmeneta
Sample Information
DIME Sample ID: 2019-02-07-2
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Threaded Bar
Sample Taken Date: 02/07/2019
Date that the sample was received by the laboratory/organization performing the testing: 02/07/2019
The quantity of what the sample constitutes: 4
A brief description of the sample: Connection Bolts
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Cosmec
Material Information
Production or Authorization Testing: Production Testing
Threaded Bar Specification: ASTM A325
Threaded Bar Grade: 325
Threaded Bar Type:
Rebar Size:
Nut Specification for Threaded Bar: ASTM A194-2H
System Manufacturer: Unkown
Epoxy Coating Color: NA
Threaded Bar Application: Threaded Bar
Coating Standards: ASTM A123 galvanized
Bar Heat Number(s): DL15105889
Nut Heat Number(s): 100793544
Bar Lot Number: 373303A
Nut Lot Number: 410347C
Coupler Heat Number(s): Unknown
Coupler Grade: Unknown
Test Results
