Sample Record for 2021-09-08-2
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Project Information
Project ID: 215255 DEA: 040A7714 EFIS: 0420000287
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-80-6.4-6.6
Work Description: CONSTRUCT PEDESTRIAN OVERCROSSING BRIDGE AND RETAINING WALLS. GILMAN INTERCHANGE IMPROVEMENTS
Location Description: ALAMEDA COUNTY IN BERKELEY FROM 0.6 MILE NORTH OF UNIVERSITY AVENUE OVERCROSSING TO 0.1 MILE SOUTH OF GILMAN STREET UNDERCROSSING
Contractor Name: Golden State Bridge
Contractor Address: 3701 Mallard Drive, Benicia, CA 94510
Resident Engineer: Rebecca Perng Structure Rep.: Eric Urmeneta
Sample Information
DIME Sample ID: 2021-09-08-2
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: 09/08/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/10/2021
The quantity of what the sample constitutes: 114
A brief description of the sample: #6 HRC 150 T Head
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Headed Reinforcement Corp, Fountain Valley, CA
Material Information
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 4111055
Head Manufacturer Lot Number(s): 1
Rebar Size: #6
Headed Bar Model Name: HRC 150
Size of Head: Full Size - 9x
Head Connection Type: Friction Weld
Head Shape: Circular
Rebar Manufacturer: CMC Steel Arizona
Head Manufacturer: Headed Reinforcement Corp
Head Fabricator: Headed Reinforcement Corp
Material Standard Code: ASTM A706
Headed Bar Unique ID:
Test Results
