Sample Record for 2023-11-06-10
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994326 DEA: 051C3604 EFIS: 0512000134
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-217-0.9/1.4
Work Description: REPLACE BRIDGE.
Location Description: SANTA BARBARA COUNTY NEAR GOLETA FROM 0.2 MILE EAST OF GOLETA SLOUGH BRIDGE TO 0.4 MILE EAST OF SAN JOSE CREEK BRIDGE
Contractor Name: MCM CONSTRUCTION
Contractor Address: 6413 32nd Street, North Highlands, Ca 95660
Resident Engineer: Manny Yogarajah Structure Rep.: Alis Chhay
Sample Information
DIME Sample ID: 2023-11-06-10
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 Control
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 11/06/2023
Date that the sample was received by the laboratory/organization performing the testing: 11/07/2023
The quantity of what the sample constitutes: 4 Couplers from 150
A brief description of the sample: #8 bar HRC 500-510 Couplers
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Integrity Rebar Placers
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Vinton Steel
Coupler Manufacturer: HRC Fountian Valley CA
Intermediate Assembler or Fabricator: Integrity Rebar Placers
Rebar Size: #8
Coupler Model: HRC 500/510
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): 5395277/5395277
Rebar Heat Number(s): 2321443
Rebar Size 2 : 8
Coupler Unique ID: TP-17-03
Test Results
