Sample Record for 2019-06-20-9
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 213852 DEA: 034F6004 EFIS: 0314000228
QA Service Level: 1
DIST-CO-RTE-PM: 03-NEV-80-1.2/R9.4
Work Description: REMOVE METAL BEAM GUARD RAIL AND REPLACE WITH CONCRETE BARRIER
Location Description: NEVADA COUNTY IN AND NEAR TRUCKEE AT VARIOUS LOCATIONS FROM 1.3 MILES WEST OF SODA SPRINGS OVERCROSSING TO 0.3 MILE EAST OF DONNER LAKE UNDERCROSSING
Contractor Name: ROAD AND HIGHWAY BUILDERS OF CALIFORNIA, INC.
Contractor Address: 175 SOLOMON CIR. #103, SPARKS, NV 89434
Resident Engineer: RANDY STELLHORN Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2019-06-20-9
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: Acceptance
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 06/20/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 2 ea heat
A brief description of the sample: #5 epoxy rebar
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC Rebar
Material Information
Rebar Heat Number(s): 4086945, 4085738, 4085737
Rebar Epoxy Batch Number(s): VD48036NA
Rebar Coating Specification: ASTM A775
Rebar Size (#): 5
Rebar Coating Color: Green
Rebar Manufacturer: CMC Rebar
Rebar Coater: CMC Rebar Brighton
Rebar Powder Manufacturer:
Release Number:
Quality Assurance Code:
Test Results
