Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 88888 DEA: SMTL-STOCK EFIS: SMTL-STOCK
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for SMTL stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2025-06-13-70
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (213) 505-4213
Type of Sample: Authorization
Type of Material: SMTL TM5 - Threaded Bar
Sample Taken Date: 06/13/2025
Date that the sample was received by the laboratory/organization performing the testing: 08/27/2025
The quantity of what the sample constitutes: NA
A brief description of the sample: 1-1/4 inch, ASTM A722 , Grade 150 Ksi Threaded bar anchorage system
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: William Form Engineering
Production or Authorization Testing: Authorization Testing
Threaded Bar Specification: ASTM A722
Threaded Bar Grade: 150
Threaded Bar Type: Deformed
Rebar Size: #10
Nut Specification for Threaded Bar: ASTM E112
System Manufacturer: William Forms
Epoxy Coating Color: NA
Threaded Bar Application: Threaded Bar
Coating Standards: Uncoated
Bar Heat Number(s): 58061592
Nut Heat Number(s): 90818
Bar Lot Number:
Nut Lot Number:
Coupler Heat Number(s): C228246
Coupler Grade:
DIME Test ID: 2025-06-13-70-1
Test Method: ASTM A722-18: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
Verified Date: 02/17/2026
Date Tested: 09/22/2025
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:
|
Number of Threaded Bar Samples
|
6
|
| Sample | Size | Mfg Lot | Area (sqin) | Tensile Strength (psi) | Stress at Offset (psi) | Total Elongation (%) | Reduction of area (%) | Comments | Tested By | | 1 | 1 1/4 | 58061592 | 1.25 | 156400 | 124800 | 0 | 0 | NA | Miguel Baltazar | | 2 | 1 1/4 | 58061592 | 1.25 | 154400 | 122400 | 0 | 0 | NA | Miguel Baltazar | | 3 | 1 1/4 | 58061592 | 1.25 | 164300 | 144400 | 0 | 0 | NA | Miguel Baltazar | | 4 | 1 1/4 | 58061592 | 1.25 | 162100 | 135800 | 0 | 0 | NA | Miguel Baltazar | | 5 | 1 1/4 | 58061592 | 1.22 | 154000 | 137700 | 9 | 35 | NA | Miguel Baltazar | | 6 | 1 1/4 | 58061592 | 1.25 | 161300 | 135800 | 0 | 0 | NA | Miguel Baltazar |
| |
|
Temperature
|
0 f
|
|
UTM
|
NA
|
DIME Test ID: 2025-06-13-70-2
Test Method: ASTM A722-18: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
Verified Date: 02/17/2026
Date Tested: 12/11/2025
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:
|
Number of Threaded Bar Samples
|
2
|
| Sample | Size | Mfg Lot | Area (sqin) | Tensile Strength (psi) | Stress at Offset (psi) | Total Elongation (%) | Reduction of area (%) | Comments | Tested By | | 7 | 1 1/4 | 58061592 | 1.25 | 161300 | 132100 | 9 | 0 | NA | Atlas | | 8 | 1 1/4 | 58061592 | 1.25 | 163500 | 132100 | 9 | 0 | NA | Atlas |
| |
|
Temperature
|
0 f
|
|
UTM
|
NA
|
