Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000409 DEA: 051S1604 EFIS: 0524000176
QA Service Level: 1
DIST-CO-RTE-PM: 05-MON-1-60
Work Description: Rocky Creek Slip Out Permanent Restoration Project
Location Description:
Contractor Name: Gordon N Ball, Inc. (Fred Velasco/Stuart Yamamoto)
Contractor Address: 333 Camille Avenue, Alamo, CA 94507
Resident Engineer: Jorge Uberhuaga Structure Rep.: Daniel Dait
DIME Sample ID: 2025-05-09-7
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 05/09/2025
Date that the sample was received by the laboratory/organization performing the testing: 05/15/2025
The quantity of what the sample constitutes: 4
A brief description of the sample: 4 samples (1 Lot) of #11 Rebar with HRC heads
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Camblin Steel
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 9003128
Head Manufacturer Lot Number(s): N/A
Rebar Size: #11
Headed Bar Model Name: HRC
Size of Head: Reduced Size - 4x
Head Connection Type: Forged
Head Shape: Circular
Rebar Manufacturer: CMC
Head Manufacturer: HRC
Head Fabricator: Camblin Steel
Material Standard Code: ASTM A706
Headed Bar Unique ID: 4FG-17-01
DIME Test ID: 2025-05-09-7-1
Test Method: ASTM A970-18: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 05/27/2025
Date Tested: 05/27/2025
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: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Number of Headed Bar Samples
|
4
|
| Lot # | Area (sqin) | Peak Load (lbf) | Tensile Strength (psi) | Comments | Tested By | | 1 | 1.56 | 146350 | 94000 | Ok Necking | Kleinfelder | | 1 | 1.56 | 148420 | 95000 | Ok Necking | Kleinfelder | | 1 | 1.56 | 146950 | 94000 | Ok Necking | Kleinfelder | | 1 | 1.56 | 146910 | 94000 | Ok Necking | Kleinfelder |
| |
|
Temperature
|
0 f
|
|
UTM
|
NA
|
