Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995498 DEA: 072XL104 EFIS: 0724000158
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-10-14.23
Work Description: Column Casings Repair Work
Location Description:
Contractor Name: SECURITY PAVING COMPANY INC
Contractor Address: 13170 TELEFAIR AVE, SYLMAR, CA 91342
Resident Engineer: Sepand Minovi Structure Rep.: Suh Kwangsuk
DIME Sample ID: 2023-11-17-46
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (530) 329-6527
Type of Sample: Per Request
Type of Material: SMTL TM6 - Ductile Iron Cast Samples
Sample Taken Date: 11/17/2023
Date that the sample was received by the laboratory/organization performing the testing: 11/17/2023
The quantity of what the sample constitutes: 1 #11 bar, 2 #4 bars, 1 #5 bar
A brief description of the sample: Rebar from I-10 fire
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Unknown
Heat Number (s): NA
Part Number (s): NA
Material Specification: N/A
Grades: N/A
Metal Foundry Manufacturer (Mill): NA
Prestressing Manufacturer: NA
DIME Test ID: 2023-11-17-46-1
Test Method: ASTM A370-20: Standard Test Methods and Definitions for Mechanical Testing of Steel Products (Tensile - Round Sample)
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
Data has not been verified.
