Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 88887 DEA: PC-Barrier-STOCK EFIS: PC-Barrier-STOCK
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for precast barrier rail stock material.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2022-11-03-2
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: Authorization
Type of Material: SMTL TM5 - Welded Hoops
Sample Taken Date: 11/03/2022
Date that the sample was received by the laboratory/organization performing the testing: 11/04/2022
The quantity of what the sample constitutes: 10 Hoops
A brief description of the sample: ASTM A 706 #6 bar 3'-8" dia.
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: RKR Steel Welding
Production or Authorization Testing: Authorization Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 1202035066
Hoop Manufacturer Lot Number(s): Lot 1
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: #6
Diameter of Hoop: 3'-8"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: Nucor
Welding Company: RKR Steel Welding
Coating Standards: Uncoated
Weld Type: Flash Welded
