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Sample Record for 2019-04-25-2

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

Project Information

Project ID: 213526 DEA: 044G9204 EFIS: 0413000062 QA Service Level: 1
DIST-CO-RTE-PM: 04-NAP-121-PM6.4
Work Description: REPAIR CORRODED STEEL REINFORCEMENT AND CONCRETE SPALLS
Location Description: NAPA COUNTY ON ROUTE 121 AT TULUCAY CREEK BRIDGE
Contractor Name: AMERICAN CIVIL CONSTRUCTORS WEST COAST LLC
Contractor Address: 2990 BAY VISTA COURT, SUITE D, BENICIA, CA 94510
Resident Engineer: DARREN ISADA Structure Rep.: MOHAMMAD NASIM

Sample Information

DIME Sample ID: 2019-04-25-2
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 Control
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 04/25/2019
Date that the sample was received by the laboratory/organization performing the testing: 04/29/2019
The quantity of what the sample constitutes: 2 lots (240 pcs)
A brief description of the sample: #8 HRC 555T-headed Bars
From where was the sample collected: Fabricator
Laboratory sample identification: 2428
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: HRC

Material Information

Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 033631
Head Manufacturer Lot Number(s): 82624781
Rebar Size: 8
Headed Bar Model Name: HRC 555 T Heads
Size of Head: Reduced Size - 4x
Head Connection Type: Friction Weld
Head Shape: Circular
Rebar Manufacturer: CMC Steel California
Head Manufacturer: HRC 555 T Heads
Head Fabricator: HRC
Material Standard Code: ASTM A706
Headed Bar Unique ID:

Test Results