Sample Record for 2019-10-08-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 213477 DEA: 080H4704 EFIS: 0812000074
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-2-2.44
Work Description: WIDEN BRIDGE TO ACCOMMODATE STANDARD SHOULDERS
Location Description: AT WRIGHTWOOD AT SHEEP CREEK BRIDGE
Contractor Name: BEADOR CONSTRUCTION
Contractor Address: 26320 LESTER CIRCLE, CORONA, CA 92883
Resident Engineer: John Santos Structure Rep.: Md Rahman
Sample Information
DIME Sample ID: 2019-10-08-2
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 - Headed Bars
Sample Taken Date: 10/08/2019
Date that the sample was received by the laboratory/organization performing the testing: 10/11/2019
The quantity of what the sample constitutes: 16
A brief description of the sample: BPI Type BNX Button Head
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Camblin Steel
Material Information
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 4087786
Head Manufacturer Lot Number(s): A177060
Rebar Size: 9
Headed Bar Model Name: BPI 09BNX
Size of Head: Full Size - 9x
Head Connection Type: Crimped Head
Head Shape: Circular
Rebar Manufacturer: CMC Arizona
Head Manufacturer: BarSplice Products
Head Fabricator: Camblin Steel
Material Standard Code: ASTM A706
Headed Bar Unique ID:
Test Results
