Sample Record for 2023-05-24-4
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 215741 DEA: 01366004 EFIS: 0100000127
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-101-80.0/84.0
Work Description: Indianola Cutoff UC
Location Description: HUMBOLDT COUNTY NEAR EUREKA FROM EUREKA SLOUGH BRIDGE TO BAYSIDE CUTOFF
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 1324 S. State Street, Ukiah, CA 95482
Resident Engineer: Jeffrey Zimmerer Structure Rep.: Danny La Londe
Sample Information
DIME Sample ID: 2023-05-24-4
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Quality Control
Type of Material: SMTL TM5 - Welded Hoops
Sample Taken Date: 05/24/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/24/2023
The quantity of what the sample constitutes: 150
A brief description of the sample: #5 bar 1'-6.5" diameter
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Conco Companies Benicia
Material Information
Production or Authorization Testing: Authorization Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 4115946 4127485 4126773
Hoop Manufacturer Lot Number(s): 1
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: #5
Diameter of Hoop: 1'-6.5"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: Nucor
Welding Company: Conco Companies Benicia
Coating Standards: Uncoated
Weld Type: Flash Welded
Test Results
