Sample Record for 2022-04-14-4
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214337 DEA: 080E33U4 EFIS: 0817000075
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-115-R7.3/R10.0
Work Description: ADD WB AUX & EB DECEL LANES, WIDEN I15 SW CONNECT,RAMPS/BRDG
Location Description: SAN BERNARDINO COUNTY IN ONTARIO FROM 0.2 MILE WEST OF CUCAMONGA CREEK BRIDGE TO MILLIKEN AVENUE
Contractor Name: Ames Construction
Contractor Address: 391 North Main Street, Suite 302, Corona, CA 92880
Resident Engineer: Denise Sostrom Structure Rep.: Matt Bruce
Sample Information
DIME Sample ID: 2022-04-14-4
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: 04/14/2022
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 120
A brief description of the sample: Number 8 HRC 555 Headed Bars
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Integrity Rebar
Material Information
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 2020751
Head Manufacturer Lot Number(s): 2020751
Rebar Size: #8
Headed Bar Model Name: HRC 555
Size of Head: Reduced Size - 4x
Head Connection Type: Forged
Head Shape: Circular
Rebar Manufacturer: Vinton Steel
Head Manufacturer: ArcelorMittal
Head Fabricator: Vinton Steel
Material Standard Code: ASTM A706
Headed Bar Unique ID:
Test Results
