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Sample Record for 2019-08-22-1


Project Information

Project ID: 211775 DEA: 024E6504 EFIS: 0212000012 QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-96-R52.5/88.4
Work Description: WIDEN BRIDGES,POLYESTER CONC OVERLAY,COLD PLANE AC PVMT,HMA,GUARDRAIL
Location Description: SISKIYOU COUNTY NEAR SEIAD VALLEY AT VARIOUS LOCATIONS FROM 0.1 MILE WEST OF THOMPSON CREEK BRIDGE TO 0.2 MILE EAST OF BEAVER CREEK BRIDGE
Contractor Name: J.F. Shea Construction, Inc Contractor Address: 17400 Clearcreek Road
Resident Engineer: Mark Loader Structure Rep.: Thompson, Robert

Sample Information

DIME Sample ID: 2019-08-22-1
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Los Angeles Field Laboratory
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Control
Type of Material: SMTL TM5 - Welded Hoops
Sample Taken Date: 08/22/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 132
A brief description of the sample: #6 1'-8" diameter flash welded hoops
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 9001269
Hoop Manufacturer Lot Number(s): 2 of 2
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: 6
Diameter of Hoop: 1'-8"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: CMC Steel CA
Welding Company: RKR Steel Welding
Coating Standards: Uncoated
Weld Type: Flash Welded