Sample Record for 2020-09-09-9
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214176 DEA: 033F0904 EFIS: 0312000056
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC,SJ-5,160-Var
Work Description: REPLACE STRUCTURAL CONCRETE BRIDGES, PLACE CIDH & CISS CONCRETE PILES.
Location Description: SACRAMENTO COUNTY AT NORTH SACRAMENTO UNDERCROSSING AND SACRAMENTO RIVER BRIDGE AND IN SAN JOAQUIN COUNTY AT MOKELUMNE RIVER BRIDGE
Contractor Name: Myers & Sons Construction
Contractor Address: 4600 Northgate Boulevard, Suite 100, Sacramento, CA 95834-1121
Resident Engineer: Mohssen Ghassemi Structure Rep.: Chuck Pazzi
Sample Information
DIME Sample ID: 2020-09-09-9
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 09/09/2020
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 4 Coupler Assemblies
A brief description of the sample: #8 Rebar coupled with #8 HRC 500/510 Couplers
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Camblin Steel
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: CMC
Coupler Manufacturer: HRC
Intermediate Assembler or Fabricator:
Rebar Size: #8
Coupler Model: HRC 500/510
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): A193741
Rebar Heat Number(s): 3096949
Rebar Size 2 :
Coupler Unique ID:
Test Results
