Sample Record for 2025-06-17-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000665 DEA: 081K4004 EFIS: 0819000031
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-15-3.5/6.8
Work Description: HMA (TYPE A), RDWY EXC, STR CONC RET WALL, RUBBERIZED HMA (OGFC).
Location Description: TEMECULA FROM 0.1 MI NORTH OF TEMECULA PARKWAY TO 0.2 MI NORTH OF WINCHESTER ROAD
Contractor Name: BEADOR CONSTRUCTION COMPANY, INC.
Contractor Address: 2900 Bristol Street, Suite D204, Costa Mesa, CA 92626
Resident Engineer: Denise Sostrom Structure Rep.: Gizachew Abayneh
Sample Information
DIME Sample ID: 2025-06-17-2
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: 06/17/2025
Date that the sample was received by the laboratory/organization performing the testing: 06/26/2025
The quantity of what the sample constitutes: 4 Samples from 63 pcs
A brief description of the sample: #9 gr75 all Threaded bars
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Williams Form Engineering-SD
Material Information
Production or Authorization Testing: Production Testing
Threaded Bar Specification: ASTM A615
Threaded Bar Grade: 75
Threaded Bar Type: Deformed
Rebar Size: #9
Nut Specification for Threaded Bar: ASTM A29/A108
System Manufacturer: William Form Enginering
Epoxy Coating Color: Purple
Threaded Bar Application: Soil Nail
Coating Standards: ASTM A934 epoxy
Bar Heat Number(s): 1000124347
Nut Heat Number(s): 5395713
Bar Lot Number: Lot 1 (63 ea.)
Nut Lot Number: Lots 1-2 (292 ea.)
Coupler Heat Number(s): N.A
Coupler Grade: N.A
Test Results
Test 1 of 1
DIME Test ID: 2025-06-17-2-1
Test Method: ASTM A615-20: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 07/03/2025
Date Tested: 07/03/2025
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: 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 Samples
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2
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| Sample | Size | Mfg Lot | Area (sqin) | Tensile Strength (psi) | Stress at Offset (psi) | Total Elongation (%) | Comments | Tested By | | 1 | 9 | 1000124347 | 1 | 127000 | 97000 | 6.6 | A615 Bar and Nut | Kleinfelder | | 2 | 9 | 1000124347 | 1 | 127000 | 97000 | 0000 | A615 Bar and Nut | Kleinfelder |
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Temperature
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0 f
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|
UTM
|
NA
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