Sample Record for 2021-10-19-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 215486 DEA: 040A0204 EFIS: 0400000129
QA Service Level: 1
DIST-CO-RTE-PM: 04-SON-1-15-15.7
Work Description: Construct roadway and bridge with structural concrete and CIDH piling
Location Description: District-County-Route-Post Mile: 04-Son-1-R15.0/R15.7
Contractor Name: BRIDGEWAY CIVIL CONSTRUCTORS, INC.
Contractor Address: 4950 Allison Parkway, # A, Vacaville, CA 95688
Resident Engineer: Fabio La Serna Structure Rep.: Bunma Nou
Sample Information
DIME Sample ID: 2021-10-19-2
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: 10/19/2021
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 62
A brief description of the sample: #6 x 2' - 6" welded hoop
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: TNT Rebar
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 1201021017
Hoop Manufacturer Lot Number(s): 1
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 Utah
Welding Company: TNT Rebar
Coating Standards: Uncoated
Weld Type: Flash Welded
Test Results