Sample Record for 2022-01-26-13
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214176 DEA: 033F0904 EFIS: 0312000056
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC,SJ-5,160-Var
Work Description: REPLACE STRUCTURAL CONCRETE BRIDGES, PLACE CIDH & CISS CONCRETE PILES.
Location Description: SACRAMENTO COUNTY AT NORTH SACRAMENTO UNDERCROSSING AND SACRAMENTO RIVER BRIDGE AND IN SAN JOAQUIN COUNTY AT MOKELUMNE RIVER BRIDGE
Contractor Name: Myers & Sons Construction
Contractor Address: 4600 Northgate Boulevard, Suite 100, Sacramento, CA 95834-1121
Resident Engineer: Mohssen Ghassemi Structure Rep.: Chuck Pazzi
Sample Information
DIME Sample ID: 2022-01-26-13
TL Number from the TL Form: None
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (530) 329-6527
Type of Sample: Per Request
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 01/26/2022
Date that the sample was received by the laboratory/organization performing the testing: 02/02/2022
The quantity of what the sample constitutes: 1 bar
A brief description of the sample: 1.25" Square rebar
From where was the sample collected: Job Site
Laboratory sample identification: None
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Unknown
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Service
Material Standard Code: ASTM A615
Material Grade: 40
Rebar Manufacturer: Unknown
Coupler Manufacturer: Unknown
Intermediate Assembler or Fabricator:
Rebar Size: #11
Coupler Model: Unknown
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): Unknown
Rebar Heat Number(s): Unknown
Rebar Size 2 : 11
Coupler Unique ID:
Test Results
