Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215425 DEA: 06360244 EFIS: 0613000005
QA Service Level: 1
DIST-CO-RTE-PM: 06-TUL-99-30.6/35.2
Work Description: Widen Freeway & Bridge Construction (Concrete Bridge)
Location Description:
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 13170 TELFAIR AVE, SYLMAR, CA, 91342
Resident Engineer: Javier Huerta Structure Rep.: Ramandeep Guraya
DIME Sample ID: 2021-09-30-6
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: 09/30/2021
Date that the sample was received by the laboratory/organization performing the testing: 10/07/2021
The quantity of what the sample constitutes: (16) #7 9'-8" Ø Lot 1 thru 4
A brief description of the sample: #7 9'-8" Ø Lot 1 thru 4
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): 3103807
Hoop Manufacturer Lot Number(s): Lot 1 thru 4
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: #7
Diameter of Hoop: 9'-3"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: CMC Rebar
Welding Company: TNT Rebar
Coating Standards: Uncoated
Weld Type: Flash Welded
