Sample Record for 2020-01-30-7
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 9999 DEA: 00000000 EFIS: 0000000000 COOP: 99999333399 MINOR: 333333 Permit Numbers: 555555 0400NRT0000
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: YYZ
Contractor Address: 1234 address, Sacramento, CA 95824
Resident Engineer: RE_first RE_last Structure Rep.: SR_First SR_Last
Sample Information
DIME Sample ID: 2020-01-30-7
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: Department Acceptance
Type of Material: SMTL TM5 - Welded Hoops
Sample Taken Date: 01/30/2020
Date that the sample was received by the laboratory/organization performing the testing: 02/04/2020
The quantity of what the sample constitutes: 10
A brief description of the sample: #9 Janda Resistance Flash Welder #F-3612
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Martinez Steel Corporation
Material Information
Production or Authorization Testing: Authorization Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 1202007086
Hoop Manufacturer Lot Number(s): 1
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: 9
Diameter of Hoop: 4'-8"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: Nucor Utah
Welding Company: Martinez Steel Corporation
Coating Standards: Uncoated
Weld Type: Flash Welded
Test Results
