Project Information

Project ID: 208682 DEA: 083401U4 EFIS: 0800000609 QA Service Level: 1

DIST-CO-RTE-PM: 08-SBD-138,138-6.2/6.4,2.3/R15.2

Work Description: WIDEN TO 4 LNS FR BEEKLEY RD TO JCT 15, ADD 1 LN EB FR PHELAN RD TO

Location Description: SAN BERNARDINO COUNTY ON ROUTE 138 NEAR PHELAN FROM 0.6 MILE WEST OF PHELAN ROAD TO THE JUNCTION OF ROUTE 15 AND ON ROUTE 2 FROM 0.1 MILE NORTH OF WILD HORSE CANYON ROAD TO ROUTE 138

Contractor Name: Flatiron

Contractor Address: 1770 LA COSTA MEADOWS DRIVE, SAN MARCOS CA 92078

Resident Engineer: Elvira Lenart Structure Rep.: Osama Abdalla

Sample Information

DIME Sample ID: 2017-05-02-5

TL Number from the TL Form: C970783

Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory

Sample Organization Contact: (530) 329-6527

Type of Sample: Quality Assurance

Type of Material: SMTL TM7 - Epoxy Coated Rebar

Sample Taken Date: 05/02/2017

Date that the sample was received by the laboratory/organization performing the testing: 05/04/2017

The quantity of what the sample constitutes: 2

A brief description of the sample: Epoxy Coated Rebar

From where was the sample collected: Fabricator

Laboratory sample identification: Unknown

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: Western Coating

Material Information

Rebar Heat Number(s): PL17102202 PL17202219

Rebar Epoxy Batch Number(s): 3506510

Rebar Coating Specification: ASTM A775

Rebar Size (#): 5

Rebar Coating Color: Green

Rebar Manufacturer: Nucor

Rebar Coater: Western Coating

Rebar Powder Manufacturer: Axalta,NapGard

Release Number: Unknown

Quality Assurance Code: Unknown

Test Results

Test 1 of 1

DIME Test ID: 2017-05-02-5-1

Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)

Verified Date: 05/09/2017

Date Tested: 05/09/2017

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

General Comments for this Test:

Test Result Compliance:

Additional Comments When Verified:

First Bar Mean	7.28 mils
Second Bar Mean	6.95 mils
Lower spec. limit LSL	7 mils
Upper spec. limit USL	12 mils
Bar # for First Bar	no data
Bar # for Second Bar	no data
Total mean value	7.11 mils
Total number of values less than LSL	no data
Total number of values greater than USL	no data

Tests Assigned to this Sample