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Sample Record for 2021-02-19-24

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 214937 DEA: 11288834 EFIS: 1117000088 QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-11,125,905-various
Work Description: CONSTRUCT CONCRETE BRIDGE, PAVEMENT, BARRIER, AND INSTALL LIGHTING. HPLUL-6211(133) SR-125 SB to WB SR-905
Location Description: SAN DIEGO COUNTY IN AND NEAR SAN DIEGO AT ROUTE 11/125/905 SEPARATION
Contractor Name: FLATIRON WEST INC
Contractor Address: 16470 W. Bernardo Drive, Suite 120, San Diego CA 92127
Resident Engineer: Nikki Tiongco Structure Rep.: Charak, Michael

Sample Information

DIME Sample ID: 2021-02-19-24
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Los Angeles Field Laboratory
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Control
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 02/19/2021
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 4
A brief description of the sample: #14 HRC Type 555
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC

Material Information

Production or Authorization Testing: Authorization Testing
Rebar Heat Number(s): 1066919
Head Manufacturer Lot Number(s): Lot 1
Rebar Size: #14
Headed Bar Model Name: Type 555
Size of Head: Reduced Size - 4x
Head Connection Type: Forged
Head Shape: Circular
Rebar Manufacturer: CMC Steel CA
Head Manufacturer: HRC
Head Fabricator: CMC San Bernardino
Material Standard Code: ASTM A706

Test Results

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.