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Sample Record for 2017-08-01-7

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 212523 DEA: 033H3504 EFIS: 0317000327 QA Service Level: 1
DIST-CO-RTE-PM: 03-SIE-49-45.19
Work Description: Construct Viaduct and re-establish both lanes of travel
Location Description:
Contractor Name: Golden State Bridge
Contractor Address: 3701 Mallard Drive, Benicia, CA 94510
Resident Engineer: Tim Crosby Structure Rep.: Jimmer Ross

Sample Information

DIME Sample ID: 2017-08-01-7
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Verification
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 08/01/2017
Date that the sample was received by the laboratory/organization performing the testing: 08/02/2017
The quantity of what the sample constitutes: 1 truck load
A brief description of the sample: 5 A775 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): 4065349, 4065348
Rebar Epoxy Batch Number(s): 7696024903
Rebar Coating Specification: ASTM A775
Rebar Size (#): 5
Rebar Coating Color: Green
Rebar Manufacturer: CMC
Rebar Coater: Western Coating
Rebar Powder Manufacturer: Valspar
Release Number: 36420
Quality Assurance Code: Unknown
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2017-08-01-7-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 08/04/2017
Date Tested: 08/04/2017
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 10.84 mils
Second Bar Mean 11.38 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 11.11 mils
Total number of values less than LSL no data
Total number of values greater than USL no data

Test 2 of 2

DIME Test ID: 2017-08-01-7-2
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 08/04/2017
Date Tested: 08/04/2017
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:
Total Number of Holiday no data0
Total Length 5 ft
Holidays Per Linear Foot of Bar no data0 holiday per ft
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass