Sample Record for 2019-04-03-4
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 213469 DEA: 024C40V4 EFIS: 0218000125
QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA-5-R3.8/R11.7
Work Description: WIDEN TO 6 LANES, BRIDGE REPLACEMENT AND WIDENING AND ROADWAY REHAB
Location Description: SHASTA COUNTY IN AND NEAR ANDERSON FROM ROUTE 5/273 SEPARATION TO 0.4 MILE SOUTH OF CHURN CREEK ROAD OVERCROSSING
Contractor Name: J.F. SHEA CONSTRUCTION
Contractor Address: P.O. BOX 494519, REDDING, CA 96049-4519
Resident Engineer: Henry Benner Structure Rep.: Eric Chaffee
Sample Information
DIME Sample ID: 2019-04-03-4
TL Number from the TL Form: 946982
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 - Welded Hoops
Sample Taken Date: 04/03/2019
Date that the sample was received by the laboratory/organization performing the testing: 04/05/2019
The quantity of what the sample constitutes: 820
A brief description of the sample: #8 7'-0" Diameter hoops
From where was the sample collected: Fabricator
Laboratory sample identification: 5843
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC Rebar
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Service
Rebar Heat Number(s): 9000204
Hoop Manufacturer Lot Number(s): 17-21
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: 8
Diameter of Hoop: 7'-0"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: CMC Steel AZ
Welding Company: CMC Rebar (Etiwanda)
Coating Standards: Uncoated
Weld Type: Flash Welded
Test Results
