Sample Record for 2020-06-17-5
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 212501 DEA: 022E4804 EFIS: 0200000586
QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-96,263-103.1/103.6,56.8/57.2
Work Description: BRIDGE REPLACEMENT
Location Description: SISKIYOU COUNTY ABOUT 8 MILES NORTH OF YREKA ON ROUTE 96 FROM 0.5 MILE WEST TO 0.2 MILE EAST OF ROUTE 263 AND ON ROUTE 263 FROM 0.3 MILE NORTH OF SHASTA RIVER BRIDGE #02-0014 TO ROUTE 96
Contractor Name: Golden State Bridge
Contractor Address: 3701 Mallard Drive, Benicia, CA 94510
Resident Engineer: Nicole Mallory Structure Rep.: Andy O'Sullevan
Sample Information
DIME Sample ID: 2020-06-17-5
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: 06/17/2020
Date that the sample was received by the laboratory/organization performing the testing: 06/19/2020
The quantity of what the sample constitutes: 1 lot of 150 and 1 lot of 80
A brief description of the sample: #6 rebar hoops 2'-5" dia
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: TNT Rebar
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 1201021017
Hoop Manufacturer Lot Number(s): 1 and 2
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: #6
Diameter of Hoop: 2'-5"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: Nucor
Welding Company: TNT Rebar
Coating Standards: Uncoated
Weld Type: Flash Welded
Test Results
