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Sample Record for 2019-04-12-3

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

Project Information

Project ID: 211260 DEA: 072159U4 EFIS: 0715000160 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,ORA-5-0.0/1.5, 44.3/44.4
Work Description: CONSTRUCT HOV LANES AND MIX FLOW LANES.
Location Description: LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 TOWNSGATE RD. SUITE 200, WESTLAKE VILLAGE, CA 91361
Resident Engineer: George Saker Structure Rep.: Danny Lalonde

Sample Information

DIME Sample ID: 2019-04-12-3
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: 04/12/2019
Date that the sample was received by the laboratory/organization performing the testing: 04/12/2019
The quantity of what the sample constitutes: 4
A brief description of the sample: A-706 T-Headed Rebar
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Integrity Rebar

Material Information

Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 65032923
Head Manufacturer Lot Number(s): A177060
Rebar Size: 9
Headed Bar Model Name: Barsplice Buttonhead
Size of Head: Full Size - 9x
Head Connection Type: Crimped Head
Head Shape: Circular
Rebar Manufacturer: CMC Rebar
Head Manufacturer: Barsplice
Head Fabricator: Integrity Rebar
Material Standard Code: ASTM A706
Headed Bar Unique ID:

Test Results