Sample Record for 2025-05-09-12
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
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
Sample Information
DIME Sample ID: 2025-05-09-12
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 - Couplers
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: 8
A brief description of the sample: 8 Samples (4 ea. from total of 4 lots) of #5 Rebar with EL16SAES Form Savers
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Camblin Steel
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Nucor
Coupler Manufacturer: nVent Lenton
Intermediate Assembler or Fabricator:
Rebar Size: #5
Coupler Model: nVent Lenton Form Saver
Coating Standards: ASTM A775 epoxy
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): M0006
Rebar Heat Number(s): 1202062533, 1201061114
Rebar Size 2 :
Coupler Unique ID: ST-17-05
Test Results
Test 1 of 1
DIME Test ID: 2025-05-09-12-1
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
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: 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 Samples
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8
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| Sample | Mfg. Lot Number(s) | Size | Area (sqin) | Slip (inch) | Peak Load (lbf) | Peak Stress (psi) | Comments | Tested By | | 1 | 1-4 | 5 | 0.31 | 0.004 | 29260 | 94500 | service splice | Kleinfelder | | 2 | 1-4 | 5 | 0.31 | 0000 | 29070 | 94000 | service splice | Kleinfelder | | 3 | 1-4 | 5 | 0.31 | 0000 | 29570 | 95500 | service splice | Kleinfelder | | 4 | 1-4 | 5 | 0.31 | 0000 | 29680 | 95500 | service splice | Kleinfelder | | 1 | 1-4 | 5 | 0.31 | 0.006 | 29180 | 94000 | service splice | Kleinfelder | | 2 | 1-4 | 5 | 0.31 | 0000 | 29360 | 94500 | service splice | Kleinfelder | | 3 | 1-4 | 5 | 0.31 | 0000 | 29380 | 95000 | service splice | Kleinfelder | | 4 | 1-4 | 5 | 0.31 | 0000 | 29820 | 96000 | service splice | Kleinfelder |
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|
Temperature
|
0 f
|
|
UTM
|
NA
|
|
Halo ID
|
na
|
