Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214245 DEA: 11404604 EFIS: 1114000049
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-56-5.6
Work Description: CONSTRUCT 2 LANES, STRUCTURAL CONCRETE BRIDGE.
Location Description: SAN DIEGO COUNTY IN SAN DIEGO AT 0.5 MILE WEST OF CAMINO DEL SUR UNDERCROSSING
Contractor Name: FLATIRON WEST INC
Contractor Address: 16470 W. BERNARDO DRIVE, SAN DIEGO CA 92127
Resident Engineer: Genaro Genel Structure Rep.: Michael Charak
DIME Sample ID: 2020-01-23-1
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: 01/23/2020
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 114 Available from Lot 1
A brief description of the sample: Flash welded hoops
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC Etiwanda
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 40928669
Hoop Manufacturer Lot Number(s): 1
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: 8
Diameter of Hoop: 5'-2"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: CMC
Welding Company: CMC Etiwanda
Coating Standards: Uncoated
Weld Type: Flash Welded
