Sample Record for 2021-01-20-3
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214572 DEA: 034E62U4 EFIS: 0319000068
QA Service Level: 1
DIST-CO-RTE-PM: 03-ED-50-18.5/24.2
Work Description: CONSTRUCT UC, MED BARRIER, DRAINAGE SYSTEMS & HMA OVERLAY.
Location Description: EL DORADO COUNTY IN AND NEAR PLACERVILLE FROM MOSQUITO ROAD UNDERCROSSING TO SCHNELL SCHOOL ROAD UNDERCROSSING AND FROM 0.2 MILE WEST OF STILL MEADOW ROAD TO 0.2 MILE EAST OF CARSON ROAD
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 Townsgate Road, Suite 200, Westlake Village, CA 91361
Resident Engineer: Nathan Alterton Structure Rep.: Raymand Macy
Sample Information
DIME Sample ID: 2021-01-20-3
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: 01/20/2021
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 4 Headed Bars from lot 1
A brief description of the sample: #9 headed bars
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: HRC CMC Rebar Gerdau
Material Information
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 3096965
Head Manufacturer Lot Number(s): E1202358 17691101
Rebar Size: #9
Headed Bar Model Name: HRC 150 T Heads
Size of Head: Full Size - 9x
Head Connection Type: Friction Weld
Head Shape: Circular
Rebar Manufacturer: CMC Steel California
Head Manufacturer: HRC
Head Fabricator: Nucor and Gerdau
Material Standard Code: ASTM A706
Headed Bar Unique ID:
Test Results
