Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000274 DEA: 041X2804 EFIS: 0424000295
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-84-11.2 or 15.5
Work Description: Repair Slip Out
Location Description: Niles Canyon
Contractor Name: Pacific Coast Drilling Co., Inc. (Aaron Sykes)
Contractor Address: 364 Bellevue Ave., Santa Rosa 95407
Resident Engineer: Eddie Dike Structure Rep.: Jordan Jarosz
DIME Sample ID: 2024-04-29-4
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 - Welded Hoops
Sample Taken Date: 04/29/2024
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 8 lots (1200 hoops)
A brief description of the sample: #6 X 2'-0" Ultimate Welded Hoops Lot 1 thru 8
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: T.N.T Rebar Corp.
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Rebar Heat Number(s): 3500034162
Hoop Manufacturer Lot Number(s): Lot 1 thru 8
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: #6
Diameter of Hoop: 2'-0"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: Nucor
Welding Company: TNT Rebar Corp
Coating Standards: Uncoated
Weld Type: Flash Welded
