Sample Record for 2021-06-14-2
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Project Information
Project ID: 213749 DEA: 120C1104 EFIS: 1200000633
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-57-20.3/21.6
Work Description: SR-57 Lambert Interchange Project: WIDEN BRIDGES AND CONSTRUCT RW, SW, HMA, JPCP AND ELECTRICAL SYSTEMS.
Location Description: ORANGE COUNTY IN BREA FROM 0.6 MILE SOUTH TO 0.7 MILE NORTH OF LAMBERT ROAD UNDERCROSSING
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 13170 TELFAIR AVENUE, SYLMAR, CA 91342
Resident Engineer: Steven Kim Structure Rep.: Theodore Pham
Sample Information
DIME Sample ID: 2021-06-14-2
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 - Welded Hoops
Sample Taken Date: 06/14/2021
Date that the sample was received by the laboratory/organization performing the testing: 06/15/2021
The quantity of what the sample constitutes: 44
A brief description of the sample: #7 3'-8" Welded Hoops
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: RKR Steel Welding
Material Information
Production or Authorization Testing: Authorization Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 039421
Hoop Manufacturer Lot Number(s): 1
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: #7
Diameter of Hoop: 3'-8"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: Cascade Steel
Welding Company: RKR Steel Welding
Coating Standards: Uncoated
Weld Type: Flash Welded
Test Results
