Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 213763 DEA: 060Q19A4 EFIS: 0613000152
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-58-R99.0/R100.3
Work Description: WIDEN SHOULDERS AND REPLACE BRIDGES
Location Description: KERN COUNTY NEAR TEHACHAPI FROM 0.5 MILE WEST TO 0.8 MILE EAST OF SAND CANYON UNDERCROSSING
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 3005 James Road, Bakersfield, CA 93308
Resident Engineer: Hin Hartanto Structure Rep.: Jegbefume Adodo
DIME Sample ID: 2019-09-05-2
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 - Welded Hoops
Sample Taken Date: 09/05/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 12 Lots 1720 Total
A brief description of the sample: Resistance welded hoops
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: TNT Rebar
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 1201014208
Hoop Manufacturer Lot Number(s): 1 through 12
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: 6
Diameter of Hoop: 2'-6"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: Nucor
Welding Company: TNT Rebar Company
Coating Standards: Uncoated
Weld Type: Flash Welded
