Project Information

Project ID: 1000081 DEA: 081J5404 EFIS: 0818000069 QA Service Level: 1

DIST-CO-RTE-PM: 08-SBD-15-2.4

Work Description: CB, JPCP (RSC), STRUCTURAL CONCRETE AND MODIFYING LIGHTING SYSTEMS.

Location Description: SAN BERNARDINO COUNTY IN ONTARIO AT ROUTE 10/15 SEPARATION

Contractor Name: FLATIRON WEST, INC.

Contractor Address: 12121 Scripps Summit Drive, Suite 400, San Diego, CA 92131

Resident Engineer: Giang-Sinh Tran Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2025-12-16-5

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 TM7 - Epoxy Coated Rebar

Sample Taken Date: 12/16/2025

Date that the sample was received by the laboratory/organization performing the testing: 12/16/2025

The quantity of what the sample constitutes: 746 LF

A brief description of the sample: #6X 30" Tie Bar Basket

From where was the sample collected: Manufacturer

Laboratory sample identification:

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: Pacific Highway Products

Material Information

Rebar Heat Number(s): 4400038256

Rebar Epoxy Batch Number(s): CH1255YE

Rebar Coating Specification: ASTM A775

Rebar Size (#): 6

Rebar Coating Color: Green

Rebar Manufacturer: Nucor

Rebar Coater: Simcote

Rebar Powder Manufacturer:

Release Number:

Quality Assurance Code:

Test Results

Test 1 of 2

DIME Test ID: 2025-12-16-5-1

Test Method: ASTM A775-19: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)

Verified Date: 01/05/2026

Date Tested: 01/05/2026

Submitted By Organization: Kleinfelder - Rancho Cordova

Organization Address: 3130 Kilgore Road,

Organization City: Rancho Cordova

Organization State: CA

Organization Zipcode: 95670

Organization Email: mmlee@kleinfelder.com

Organization Phone: (916) 308-3701

General Comments for this Test:

Test Result Compliance: complies

Additional Comments When Verified:

First Bar Mean	11.33
Second Bar Mean	11.14
Lower spec. limit LSL	7
Upper spec. limit USL	16
Bar # for First Bar	1
Bar # for Second Bar	2
Total mean value	11.235
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: 2025-12-16-5-2

Test Method: ASTM A775-19: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)