Sample Record for 2025-10-08-6
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000258 DEA: 042K3604 EFIS: 0416000410
QA Service Level: 1
DIST-CO-RTE-PM: 04-SON-116-9.6
Work Description: REPAIR SIDE SLOPE AND CONSTRUCT SOIL NAIL WALL.
Location Description: SONOMA COUNTY NEAR MONTE RIO AT 0.2 MILE WEST OF CNOPIUS ROAD
Contractor Name: GHILOTTI BROS., INC.
Contractor Address: 525 Jacoby Street, San Rafael, CA 94901
Resident Engineer: Leonard Brajnikoff Structure Rep.: Alireza Jamalipour
Sample Information
DIME Sample ID: 2025-10-08-6
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: Verification
Type of Material: SMTL TM5 - Threaded Bar
Sample Taken Date: 10/08/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/14/2025
The quantity of what the sample constitutes: 60
A brief description of the sample: #11 (L.H) Grade 75 Epoxy Coated Soil Nails
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: #11
Nut Specification for Threaded Bar: ASTM A29
System Manufacturer: Williams Form Engineering San Diego
Epoxy Coating Color: Purple
Threaded Bar Application: Soil Nail
Coating Standards: ASTM A934 epoxy
Bar Heat Number(s): 1000225502
Nut Heat Number(s): 74124863
Bar Lot Number: 100022550240
Nut Lot Number: 11N5D
Coupler Heat Number(s): NA
Coupler Grade: NA
Test Results
Test 1 of 1
DIME Test ID: 2025-10-08-6-1
Test Method: ASTM A615-20: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 10/24/2025
Date Tested: 10/24/2025
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:
|
Number of Samples
|
2
|
| Sample | Size | Mfg Lot | Area (sqin) | Tensile Strength (psi) | Stress at Offset (psi) | Total Elongation (%) | Comments | Tested By | | 1 | 11 | 1000225502 | 1.56 | 112000 | 89699 | 0000 | A615 Bar and Nut | Kleinfelder | | 2 | 11 | 1000225502 | 1.56 | 113000 | 89436 | 7 | A615 Bar | Kleinfelder |
| |
|
Temperature
|
0 f
|
|
UTM
|
NA
|
