Sample Record for 2022-04-29-9
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 993235 DEA: 051H4504 EFIS: 0516000075
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-154-R31.8/R32.1
Work Description: CONSTRUCT CIDH CONCRETE PILES AND STRUCTURAL CONCRETE BRIDGE.
Location Description: SANTA BARBARA COUNTY IN AND NEAR SANTA BARBARA FROM PRIMAVERA ROAD UNDERCROSSING TO LA COLINA ROAD UNDERCROSSING
Contractor Name: CA Rasmussen
Contractor Address: 28548 LIVINGSTON AVENUE, VALENICA CA 91355
Resident Engineer: Jeffery Finn Structure Rep.: Emiliano Berntsen
Sample Information
DIME Sample ID: 2022-04-29-9
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: 04/29/2022
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: (152) 10A (Taper Threaded DoughNUT Termination System)
A brief description of the sample: (8) 9TT-17-01 Lot 1 & 2
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Martinez steel
Material Information
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 068222
Head Manufacturer Lot Number(s): Lot 1 Heat No A205893 Lot 2 Heat No A211864
Rebar Size: #14
Headed Bar Model Name: 14TDX GripTwist Doughnut 10ab
Size of Head: Full Size - 9x
Head Connection Type: Taper Threaded
Head Shape: Circular
Rebar Manufacturer: Cascade Steel
Head Manufacturer: Barsplice
Head Fabricator: Martinez Steel
Material Standard Code: ASTM A706
Headed Bar Unique ID:
Test Results
