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Sample Record for 2019-08-07-5

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Project Information

Project ID: 212743 DEA: 030H26U4 EFIS: 0317000247 QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-65-R5.0/R6.6
Work Description: NORTHBOUND WIDENING AND RAMP IMPROVEMENTS.
Location Description: PLACER COUNTY IN AND NEAR ROSEVILLE AND ROCKLIN FROM 0.1 MILE SOUTH OF EAST ROSEVILLE VIADUCT TO 0.5 MILE SOUTH OF PLEASANT GROVE BOULEVARD OVERCROSSING
Contractor Name: FLATIRON WEST INC
Contractor Address: 2100 Goodyear Rd, Benicia, CA 94510
Resident Engineer: Jeff Johnson Structure Rep.: James "Jimmer" Ross

Sample Information

DIME Sample ID: 2019-08-07-5
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 - Headed Bars
Sample Taken Date: 08/07/2019
Date that the sample was received by the laboratory/organization performing the testing: 08/12/2019
The quantity of what the sample constitutes: 2 Lots
A brief description of the sample: #5 T-Head bars
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: HRC

Material Information

Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 4088163
Head Manufacturer Lot Number(s): B1128831
Rebar Size: 5
Headed Bar Model Name: HRC 120
Size of Head: Reduced Size - 4x
Head Connection Type: Forged
Head Shape: Circular
Rebar Manufacturer: CMC Steel Arizona
Head Manufacturer: Unknown
Head Fabricator: HRC
Material Standard Code: ASTM A706
Headed Bar Unique ID:

Test Results