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Sample Record for 2019-08-06-5

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

Project Information

Project ID: 212244 DEA: 044G8404 EFIS: 0413000051 QA Service Level: 1
DIST-CO-RTE-PM: 04-NAP-128-20.1/20.4
Work Description: REPLACE CAPELL CREEK BRIDGE
Location Description: NAPA COUNTY ABOUT 15 MILES EAST OF RUTHERFORD FROM 1.1 MILES EAST OF KNOXVILLE ROAD TO 0.3 MILE WEST OF CAPELL VALLEY CREST
Contractor Name: GORDON N BALL INC
Contractor Address: 333 CAMILLE AVENUE, ALAMO CA 94507
Resident Engineer: Darren Isada Structure Rep.: Nana Budu

Sample Information

DIME Sample ID: 2019-08-06-5
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 - Couplers
Sample Taken Date: 08/06/2019
Date that the sample was received by the laboratory/organization performing the testing: 08/09/2019
The quantity of what the sample constitutes: 60
A brief description of the sample: #18 Bar Splice Coupler
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Camblin Steel Service

Material Information

Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Gerdau CMC
Coupler Manufacturer: Bar Splice
Intermediate Assembler or Fabricator: Unknown
Rebar Size: 18
Coupler Model: BarGrip XL
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter: Unknown
Rebar Hoop Fabricator: Unknown
Coupler Component Heat/Lot Number(s): A183663
Rebar Heat Number(s): 9000571, 9000568
Rebar Size 2 : 18
Coupler Unique ID:

Test Results