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Sample Record for 2020-01-27-18

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Project Information

Project ID: 213856 DEA: 112888U4 EFIS: 1118000199 QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-11,125,905-Various
Work Description: CONSTRUCT FREEWAY TO FREEWAY CONNECTORS AND 4-LANE HIGHWAY FACILITY
Location Description: SAN DIEGO COUNTY AT VARIOUS LOCATIONS
Contractor Name: Skanska USA Civil West CA
Contractor Address: 1995 Agua Mansa Road, Riverside, CA 92509
Resident Engineer: Carlos Covarrubias Structure Rep.: Wade Durant

Sample Information

DIME Sample ID: 2020-01-27-18
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: 01/27/2020
Date that the sample was received by the laboratory/organization performing the testing: 01/31/2020
The quantity of what the sample constitutes: 4 samples from Lot # 1
A brief description of the sample: #14 ASTM 706 41'-4" Both Ends Headed Bar H55
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name: S125/905 Connector
The fabricator/manufacturer/facility name: Integrity Rebar Placers

Material Information

Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 65021892
Head Manufacturer Lot Number(s): Lot 1
Rebar Size: 14
Headed Bar Model Name: NA
Size of Head: Full Size - 9x
Head Connection Type: Forged
Head Shape: Circular
Rebar Manufacturer: Gerdau
Head Manufacturer: Integrity Rebar Placers
Head Fabricator: Integrity Rebar Placers
Material Standard Code: ASTM A706
Headed Bar Unique ID:

Test Results