Sample Record for 2021-06-07-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 215257 DEA: 11056374 EFIS: 1117000087
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-11-0.6/2.7
Work Description: CONSTRUCT INTERCHANGE, PLACE JPCP, HMA, AND INSTALL LIGHTING.
Location Description: SAN DIEGO COUNTY NEAR SAN DIEGO FROM 0.2 MILE WEST OF SANYO AVENUE UNDERCROSSING TO 1.2 MILE EAST OF ENRICO FERMI DRIVE OVERCROSSING
Contractor Name: SKANSKA USA CIVIL WEST CALIFORNIA DISTRICT INC.
Contractor Address: 1995 Agua Mansa Rd, Riverside, CA 92509
Resident Engineer: Victor Cardenas Structure Rep.: Wade Durant
Sample Information
DIME Sample ID: 2021-06-07-2
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: 06/07/2021
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 56
A brief description of the sample: HRC 555 T-Heads
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC San Bernardino
Material Information
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 1066929
Head Manufacturer Lot Number(s): 1
Rebar Size: #14
Headed Bar Model Name: HRC 555
Size of Head: Reduced Size - 4x
Head Connection Type: Forged
Head Shape: Circular
Rebar Manufacturer: CMC Rancho Cucamonga
Head Manufacturer: HRC
Head Fabricator: HRC
Material Standard Code: ASTM A706
Headed Bar Unique ID:
Test Results
