Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994673 DEA: 033F0704 EFIS: 0312000054
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-51-2.0/3.5
Work Description: American River Bridge Rehabilitation
Location Description:
Contractor Name: American River Constructors
Contractor Address: 4001 Bradshaw Road, Sacramento, CA 95827
Resident Engineer: John Ruzic Structure Rep.: Pha Tran
DIME Sample ID: 2024-10-21-2
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 - Threaded Bar
Sample Taken Date: 10/21/2024
Date that the sample was received by the laboratory/organization performing the testing: 10/25/2024
The quantity of what the sample constitutes: Four (4) Threaded Bars
A brief description of the sample: Two (2) 1-3/8" Threaded Bar, four (4) 1-3/8" Nuts, and four (4) washers
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Williams Form Engineering San Diego
Production or Authorization Testing: Production Testing
Threaded Bar Specification: ASTM A722
Threaded Bar Grade: 150
Threaded Bar Type: Deformed
Rebar Size:
Nut Specification for Threaded Bar: ASTM A29
System Manufacturer: Williams Form Engineering San Diego
Epoxy Coating Color: NA
Threaded Bar Application: Soil Nail
Coating Standards: Uncoated
Bar Heat Number(s): 58052325/04
Nut Heat Number(s): 20762050
Bar Lot Number: 04
Nut Lot Number: 36G9D
Coupler Heat Number(s):
Coupler Grade:
DIME Test ID: 2024-10-21-2-2
Test Method: ASTM A722-18: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
Verified Date: 02/03/2025
Date Tested: 02/03/2025
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: brian.ellis@dot.ca.gov
Organization Phone: (916) 380-8623
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Number of Threaded Bar Samples
|
3
|
| Sample | Size | Mfg Lot | Area (sqin) | Tensile Strength (psi) | Stress at Offset (psi) | Total Elongation (%) | Reduction of area (%) | Comments | Tested By | | 1 | 0 | 58052325 | 1.58 | 166900 | 130300 | 7 | 0 | 0 | Atlas | | 2 | 0 | 58052325 | 1.58 | 164500 | 145200 | 7 | 0 | 0 | Atlas | | 3 | 0 | 58052325 | 1.58 | 159500 | 133000 | 9 | 32 | 0 | Atlas |
| |
|
Temperature
|
0 f
|
|
UTM
|
NA
|
