Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 88888 DEA: SMTL-STOCK EFIS: SMTL-STOCK
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for SMTL stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2023-10-09-4
TL Number from the TL Form: L159-245-23
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Stock
Type of Material: SMTL TM5 - Threaded Bar
Sample Taken Date: 10/09/2023
Date that the sample was received by the laboratory/organization performing the testing: 10/13/2023
The quantity of what the sample constitutes: 64
A brief description of the sample: #1.250 GR.150 Threaded Bar
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Nucor Skyline
Production or Authorization Testing: Authorization Testing
Threaded Bar Specification: ASTM A722
Threaded Bar Grade: 150
Threaded Bar Type: Deformed
Rebar Size:
Nut Specification for Threaded Bar: N/A
System Manufacturer: Nucor Skyline
Epoxy Coating Color: NA
Threaded Bar Application:
Coating Standards: Uncoated
Bar Heat Number(s): A203330,A205762
Nut Heat Number(s):
Bar Lot Number:
Nut Lot Number:
Coupler Heat Number(s):
Coupler Grade:
