Sample Record for 2019-11-14-3
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 211260 DEA: 072159U4 EFIS: 0715000160
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,ORA-5-0.0/1.5, 44.3/44.4
Work Description: CONSTRUCT HOV LANES AND MIX FLOW LANES.
Location Description: LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 TOWNSGATE RD. SUITE 200, WESTLAKE VILLAGE, CA 91361
Resident Engineer: George Saker Structure Rep.: Danny Lalonde
Sample Information
DIME Sample ID: 2019-11-14-3
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: 11/14/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 496 bars total
A brief description of the sample: Headed Bar
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier: 53-3045
Structure name: Valley View
The fabricator/manufacturer/facility name: Integrity Rebar
Material Information
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 65030893 02
Head Manufacturer Lot Number(s): 1, 2, 3, and 4
Rebar Size: 5
Headed Bar Model Name: BNX Buttonhead
Size of Head: Full Size - 9x
Head Connection Type: Friction Weld
Head Shape: Circular
Rebar Manufacturer: Gerdau
Head Manufacturer: BarSplice
Head Fabricator: BarSplice
Material Standard Code: ASTM A706
Headed Bar Unique ID:
Test Results
