Sample Record for 2022-05-06-4
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Project Information
Project ID: 214988 DEA: 050L7214 EFIS: 0515000097
QA Service Level: 1
DIST-CO-RTE-PM: 05-SLO-1-32.6
Work Description: REMOVE & CONSTRUCT CONCRETE BRIDGE, CONCRETE SLAB, BRIDGE RAIL & HMA.
Location Description: SAN LUIS OBISPO COUNTY IN MORRO BAY AT TORO CREEK BRIDGE
Contractor Name: Souza Engineering Contracting, Inc
Contractor Address: 4027 SANTA FE ROAD, SAN LUIS OBISPO CA 93401
Resident Engineer: Rick Silva Structure Rep.: Salvador Heredia
Sample Information
DIME Sample ID: 2022-05-06-4
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: 05/06/2022
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 156 Headed Bars Lot 1-2
A brief description of the sample: #10 HRC 150 T-Headed bars
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: HRC Fountain Valley
Material Information
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 4114532
Head Manufacturer Lot Number(s): MM20103137
Rebar Size: #10
Headed Bar Model Name: HRC 150 T Heads
Size of Head: Full Size - 9x
Head Connection Type: Friction Weld
Head Shape: Circular
Rebar Manufacturer: CMC Steel Arizona
Head Manufacturer: HRC Fountain Valley
Head Fabricator: HRC Fountain Valley
Material Standard Code: ASTM A706
Headed Bar Unique ID:
Test Results
