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

Sample Record for 2019-10-25-9


Project Information

Project ID: 210673 DEA: 042640F4 EFIS: 0400020132 COOP: 042308A3 QA Service Level: 1
DIST-CO-RTE-PM: 04-SON-101-4.0/7.1
Work Description: DESIGN THE NORTHERLY SEGMENT OF THE MARIN-SONOMA NARROWS PROJECT AND INCLUDES SOUND WALLS, BRIDGES, MEDIAN WIDENING AND RAMP WIDENING.
Location Description: JUST NORTH OF THE U.S. 101 AND STATE ROUTE 116 CONNECTION TO 0.3 MILE NORTH OF THE CORONA ROAD OVERCROSSING IN THE CITY OF PETALUMA.
Contractor Name: GHILOTTI CONSTRUCTION CO. INC. Contractor Address: 246 GHILOTTI AVENUE
Resident Engineer: Richard Duncan Structure Rep.: Beaudoin, Brian

Sample Information

DIME Sample ID: 2019-10-25-9
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: 10/25/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 150
A brief description of the sample: #6 5'-2" Ultimate Welded Hoop
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 9001286
Hoop Manufacturer Lot Number(s): 2
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: 6
Diameter of Hoop: 5'-2"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: CMC Steel CA
Welding Company: TNT Rebar Company
Coating Standards: Uncoated
Weld Type: Flash Welded