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Sample Record for 2021-10-25-5

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Project Information

Project ID: 215396 DEA: 042K8404 EFIS: 0417000031 QA Service Level: 1
DIST-CO-RTE-PM: 04-SOL-29,80-0.0,0.8/1.6
Work Description: HMA, STRUCTURAL CONCRETE, CIDH PILING AND REBAR.
Location Description: SOLANO COUNTY IN VALLEJO AT ROUTE 80/29 SEPARATION AND ON ROUTE 80 FROM 0.2 MILE NORTH OF CARQUINEZ BRIDGE TOLL PLAZA TO 0.3 MILE SOUTH OF MAGAZINE STREET OVERCROSSING
Contractor Name: OC Jones & Sons Inc
Contractor Address: 1520 4th Street, Berkeley, CA 94710
Resident Engineer: Noel Aquino Structure Rep.: Angelo Perez

Sample Information

DIME Sample ID: 2021-10-25-5
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Department Acceptance
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 10/25/2021
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 32
A brief description of the sample: #5 Lenton Formsaver Coupler
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Conco Reinforcing

Material Information

Production or Authorization Testing: Authorization Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: #5
Coupler Manufacturer: Erico Lenton
Intermediate Assembler or Fabricator: Conco
Rebar Size: #5
Coupler Model: Lenton Formsaver
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): 1234
Rebar Heat Number(s): 1234
Rebar Size 2 : 5
Coupler Unique ID:

Test Results