Sample Record for 2023-01-26-1
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 212737 DEA: 060S8304 EFIS: 0615000046
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-5-44.4-45.4
Work Description: TUMEY GULCH ABUTMENT REHAB BR# 42-0246L/R.
Location Description: IN FRESNO COUNTY AT TUMEY GULCH.
Contractor Name: Bruce Shumacher
Contractor Address: 2716 S Granite Ct, Fresno, CA 93706
Resident Engineer: Cary Cruz Structure Rep.: Ben Holton
Sample Information
DIME Sample ID: 2023-01-26-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 01/26/2023
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 4 bars
A brief description of the sample: HRC 555 T-Heads
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name: Tomey Gulch
The fabricator/manufacturer/facility name: Pacific Steel Group Napa
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Nucor
Coupler Manufacturer: HRC Nucor
Intermediate Assembler or Fabricator: Pacific Steel Group
Rebar Size: #8
Coupler Model: hrc555
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): 17-TH
Rebar Heat Number(s): 3500024493
Rebar Size 2 :
Coupler Unique ID: Not on AML
Test Results
