Sample Record for 2019-03-14-4
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 211235 DEA: 054482U4 EFIS: 0500000543
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-2.2/3.3
Work Description: BUILD AND RECONSTRUCT BRIDGES, CONSTRUCT RAMPS AND FRONTAGE ROAD.
Location Description: SANTA BARBARA COUNTY IN CARPINTERIA FROM 0.2 MILE SOUTH OF CARPINTERIA CREEK BRIDGE TO FRANKLIN CREEK BRIDGE
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 9050 NORRIS AVENUE, SUN VALLEY, CA 91352
Resident Engineer: Tristan Gebhart Structure Rep.: Raymond Barajas
Sample Information
DIME Sample ID: 2019-03-14-4
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 - Couplers
Sample Taken Date: 03/14/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 150
A brief description of the sample: Couplers
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Harris Rebar
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Nucor
Coupler Manufacturer: zap
Intermediate Assembler or Fabricator: Harris Rebar
Rebar Size: 10
Coupler Model: Zap
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): MM18103576 Code ED
Rebar Heat Number(s): 3500004803
Rebar Size 2 :
Coupler Unique ID:
Test Results
