Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 209820 DEA: 04297634 EFIS: 0415000040 COOP: 042548
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-84,680-17.9/21
Work Description: ROUTE 84 WIDENING (4-LANE EXPRESSWAY) FROM I-680 TO PIGEON PASS, INCLUDING INTERSECTION, DRAINAGE IMPROVEMENTS AND UTILITY RELOCATION.
Location Description: ALAMEDA COUNTY IN AND NEAR SUNOL, PLEASANTON, AND LIVERMORE ON ROUTE 84 FROM 0.1 MILE EAST OF ROUTE 680 TO 0.1 MILE SOUTH OF RUBY HILL DRIVE AND ON ROUTE 680 FROM 1.2 MILES SOUTH TO 1.8 MILES NORTH OF ROUTE 84
Contractor Name: Bay Cities Paving & Grading
Contractor Address: 1450 Civic Ct. BLDG B #400, Concord CA, 94520
Resident Engineer: Paramjit Pandher Structure Rep.: Ehab Wahed
DIME Sample ID: 2022-03-18-9
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 - Headed Bars
Sample Taken Date: 03/18/2022
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 64
A brief description of the sample: #7 HRC 120 T Heads
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name: Calaveras SB Bent 2 FTG ETC
The fabricator/manufacturer/facility name: Headed Reinforcement Corp, Fountain Valley, CA
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 6028954
Head Manufacturer Lot Number(s): 10021186321
Rebar Size: #7
Headed Bar Model Name: HRC 120
Size of Head: Full Size - 9x
Head Connection Type: Friction Weld
Head Shape: Square
Rebar Manufacturer: CMC
Head Manufacturer: Nucor
Head Fabricator: Nucor
Material Standard Code: ASTM A706
Headed Bar Unique ID:
