Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994454 DEA: 010M7304 EFIS: 0123000063
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-211-77.2/78.59999999999999
Work Description: Fernbridge Earthquake Restoration (Bridge No. 04-0134)
Location Description:
Contractor Name: Myers and Sons Construction
Contractor Address: 4600 NORTHGATE BLVD, STE 100, Sacramento, CA 95834
Resident Engineer: Tai-Aqua Morgan-Marbet Structure Rep.: Ryan Duran
DIME Sample ID: 2023-08-21-3
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 Assurance
Type of Material: SMTL TM5 - Welded Hoops
Sample Taken Date: 08/21/2023
Date that the sample was received by the laboratory/organization performing the testing: 08/22/2023
The quantity of what the sample constitutes: 36 Hoops from 1284
A brief description of the sample: #8 Hoop 5'-2" 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: Production Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 208923
Hoop Manufacturer Lot Number(s): Lots 1-9
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: #8
Diameter of Hoop: 5'-2"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: Cascade Steel
Welding Company: RKR Steel Welding
Coating Standards: Uncoated
Weld Type: Flash Welded
