Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215753 DEA: 050N72U4 EFIS: 0520000169
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-4.4/R7.7
Work Description: Please cc Office Engineer Ni Nyoman Paul on reports sent to RE and SR. Construct High Occupancy Vehicle (HOV) lanes on U.S. Route 101 and rehabilitation - Segment 4B.
Location Description: 101 freeway in Summerland, CA
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 5335 Debbie Road, Santa Barbara, CA 93111
Resident Engineer: Luobao Cai Structure Rep.: Emiliano Berntsen
DIME Sample ID: 2021-12-27-14
TL Number from the TL Form:
Sample Submitted By Organization: Granite Construction Company - Buellton
Sample Organization Contact: (805) 331-1054
Type of Sample: Quality Control
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 12/27/2021
Date that the sample was received by the laboratory/organization performing the testing: 12/28/2021
The quantity of what the sample constitutes: Lot 1 - 150 qty
A brief description of the sample: #8 HRC 150
From where was the sample collected: Job Site
Laboratory sample identification: R122721-100
Structure unique identifier:
Structure name: 920HTY, 921HTY, 924HTY, 925HTY
The fabricator/manufacturer/facility name: CMC Rebar
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 400000368821
Head Manufacturer Lot Number(s): Lot 1
Rebar Size: #8
Headed Bar Model Name: HRC 150
Size of Head: Full Size - 9x
Head Connection Type:
Head Shape: Circular
Rebar Manufacturer: CMC
Head Manufacturer: HRC
Head Fabricator: HRC
Material Standard Code: ASTM A706
Headed Bar Unique ID:
DIME Test ID: 2021-12-27-14-1
Test Method: ASTM A970-18: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Submitted By Organization: Granite Construction Company - Buellton
Organization Address: 400 South Highway ,
Organization City: Buellton
Organization State: CA
Organization Zipcode: 93427
Organization Email: kevin.rounds@gcinc.com
Organization Phone: (805) 331-1054
Data has not been verified.
