Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215620 DEA: 01436404 EFIS: 0100000193
QA Service Level: 1
DIST-CO-RTE-PM: 01-DN-101-35.8/36.5
Work Description: Dr. Fine Bridge Replacement
Location Description: DR. FINE BRIDGE REPLACEMENT FROM LAKE EARL DR TO S FRED D. HAIGHT DR ON HWY 101 ACROSS SMITH RIVER.
Contractor Name: MCM Construction
Contractor Address: PO Box 620, North Highlands, Ca 95660
Resident Engineer: Clayton Malmberg Structure Rep.: Brian Cinkutis
DIME Sample ID: 2025-05-02-65
TL Number from the TL Form:
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 TM5 - Threaded Bar
Sample Taken Date: 05/02/2025
Date that the sample was received by the laboratory/organization performing the testing: 05/14/2025
The quantity of what the sample constitutes: 3
A brief description of the sample: 3" A722 Threaded Bar
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Williams Form Eng
Production or Authorization Testing: Production Testing
Threaded Bar Specification: ASTM A722
Threaded Bar Grade: 150
Threaded Bar Type:
Rebar Size:
Nut Specification for Threaded Bar: A29
System Manufacturer: Williams Form
Epoxy Coating Color: NA
Threaded Bar Application:
Coating Standards: Uncoated
Bar Heat Number(s): 1000226351
Nut Heat Number(s): X9953
Bar Lot Number:
Nut Lot Number: 75Y2D
Coupler Heat Number(s):
Coupler Grade:
DIME Test ID: 2025-05-02-65-1
Test Method: ASTM A722-18: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
Verified Date: 07/23/2025
Date Tested: 07/23/2025
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: Did not pull to break, UTM stopped test at capacity.
Test Result Compliance:
Additional Comments When Verified:
|
Number of Threaded Bar Samples
|
3
|
| Sample | Size | Mfg Lot | Area (sqin) | Tensile Strength (psi) | Stress at Offset (psi) | Total Elongation (%) | Reduction of area (%) | Comments | Tested By | | 1 | 3 | NA | 6.85 | 0 | 129900 | 0 | 0 | NA | Smith Emery | | 2 | 3 | NA | 6.85 | 0 | 130200 | 0 | 0 | NA | Smith Emery | | 3 | 3 | NA | 6.85 | 0 | 132600 | 0 | 0 | NA | Smith Emery |
| |
|
Temperature
|
72 f
|
|
UTM
|
NA
|
