Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215424 DEA: 024G4404 EFIS: 0214000013
QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-3-38.0/38.6
Work Description: BRIDGE REPLACEMENT
Location Description: SISKIYOU COUNTY ABOUT 6 MILES NORTH OF FORT JONES FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF LOWER MOFFETT CREEK ROAD
Contractor Name: Steelhead Constructors
Contractor Address: 2940 INNSBRUCK DRIVE, REDDING CA 96003
Resident Engineer: Nicole Mallory Structure Rep.: Andy O'Sullivan
DIME Sample ID: 2021-05-28-3
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 - Welded Hoops
Sample Taken Date: 05/28/2021
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 8 lots (1200 hoops)
A brief description of the sample: #6 2'6" Dia Hoops
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: TNT Rebar
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 1201028406
Hoop Manufacturer Lot Number(s): 1 to 8
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: #6
Diameter of Hoop: 2'-6"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: Nucor
Welding Company: TNT Rebar
Coating Standards: Uncoated
Weld Type: Flash Welded
