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Sample Record for 2020-05-12-1

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Project Information

Project ID: 213682 DEA: 11430184 EFIS: 1117000215 QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-805-8.4/8.8
Work Description: Bridge widening, HMA, barrier, drainage, RCP, and landscape work near Sweetwater River Bridge in Chula Vista. Widening of Sweetwater River Bridge in Chula Vista on 805.
Location Description: Near Sweetwater River Bridge in Chula Vista on 805.
Contractor Name: Flatiron West
Contractor Address: 1770 La Costa Meadows Drive, San Marcos, CA 92078
Resident Engineer: Seid Hodzic Structure Rep.: David Toci

Sample Information

DIME Sample ID: 2020-05-12-1
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 Assurance
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 05/12/2020
Date that the sample was received by the laboratory/organization performing the testing: 05/19/2020
The quantity of what the sample constitutes: (4) #8 4 ft. long
A brief description of the sample: HRC 555 Head Bar
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Steel Group

Material Information

Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 1202016630
Head Manufacturer Lot Number(s): Lot 1, and 2
Rebar Size: #8
Headed Bar Model Name: Hot Forge Headed Bar
Size of Head: Full Size - 9x
Head Connection Type: Forged
Head Shape: Circular
Rebar Manufacturer: NUCOR
Head Manufacturer: Pacific Steel Group
Head Fabricator: Pacific Steel Group
Material Standard Code: ASTM A706
Headed Bar Unique ID:

Test Results