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

Sample Record for 2019-10-07-1


Project Information

Project ID: 213520 DEA: 120M9004 EFIS: 1213000017 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-22-R5.6/R10.9
Work Description: RECHANNELIZE TO ENHANCE TRAFFIC FLOW
Location Description: ORANGE COUNTY AT VARIOUS LOCATIONS FROM 0.1 MILE WEST OF BROOKHURST STREET UNDERCROSSING IN GARDEN GROVE TO BEDFORD ROAD OVERCROSSING IN ORANGE
Contractor Name: POWELL CONSTRUCTORS INC Contractor Address: 8555 Banana Avenue
Resident Engineer: Victor Valdovinos Structure Rep.: Pham, Theodore

Sample Information

DIME Sample ID: 2019-10-07-1
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: 10/07/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 100
A brief description of the sample: #5 rebar hoop 4'-2" diameter
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): 1201005410
Hoop Manufacturer Lot Number(s): 1
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: 5
Diameter of Hoop: 4'-2"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: Nucor Utah
Welding Company: Martinez Steel
Coating Standards: Uncoated
Weld Type: Flash Welded