Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 88888 DEA: SMTL-STOCK EFIS: SMTL-STOCK
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for SMTL stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2022-02-04-3
TL Number from the TL Form: na
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Threaded Bar
Sample Taken Date: 02/04/2022
Date that the sample was received by the laboratory/organization performing the testing: 02/04/2022
The quantity of what the sample constitutes: 37
A brief description of the sample: ASTM A449 All Thread Rod
From where was the sample collected: Fabricator
Laboratory sample identification: na
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Universal Industrial Sales Inc
Production or Authorization Testing: Authorization Testing
Threaded Bar Specification: ASTM A449
Threaded Bar Grade: 449
Threaded Bar Type: Plain
Rebar Size:
Nut Specification for Threaded Bar: na
System Manufacturer: Platte Anchor Bolt
Epoxy Coating Color: NA
Threaded Bar Application: Threaded Bar
Coating Standards: ASTM A153 galvanized
Bar Heat Number(s): DL20100222
Nut Heat Number(s): na
Bar Lot Number: DL201022254
Nut Lot Number: na
Coupler Heat Number(s): na
Coupler Grade: na
