Sample Record for 2025-12-23-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994326 DEA: 051C3604 EFIS: 0512000134
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-217-0.9/1.4
Work Description: REPLACE BRIDGE.
Location Description: SANTA BARBARA COUNTY NEAR GOLETA FROM 0.2 MILE EAST OF GOLETA SLOUGH BRIDGE TO 0.4 MILE EAST OF SAN JOSE CREEK BRIDGE
Contractor Name: MCM CONSTRUCTION
Contractor Address: 6413 32nd Street, North Highlands, Ca 95660
Resident Engineer: Manny Yogarajah Structure Rep.: Fabian Velasco
Sample Information
DIME Sample ID: 2025-12-23-2
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 TM5 - Couplers
Sample Taken Date: 12/23/2025
Date that the sample was received by the laboratory/organization performing the testing: 12/31/2025
The quantity of what the sample constitutes: 1010
A brief description of the sample: HRC 500 510 Couplers
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Integrity Rebar Placers
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Cascade Steel
Coupler Manufacturer: HRC
Intermediate Assembler or Fabricator:
Rebar Size: #9
Coupler Model: HRC 500-510
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): 500 Y5156 510 74141308
Rebar Heat Number(s): 323925
Rebar Size 2 :
Coupler Unique ID: TF-17-01
Test Results
Test 1 of 1
DIME Test ID: 2025-12-23-2-1
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
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:
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Number of Samples
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4
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| Sample | Mfg. Lot Number(s) | Size | Area (sqin) | Slip (inch) | Peak Load (lbf) | Peak Stress (psi) | Comments | Tested By | | 1 | 323925 | 9 | 1 | 0.014 | 92530 | 92500 | NA | Kleinfelder | | 2 | 323925 | 9 | 1 | 0 | 93280 | 93500 | NA | Kleinfelder | | 3 | 323925 | 9 | 1 | 0 | 91620 | 91500 | NA | Kleinfelder | | 4 | 323925 | 9 | 1 | 0 | 92960 | 93000 | NA | Kleinfelder |
| |
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Temperature
|
0 f
|
|
UTM
|
NA
|
|
Halo ID
|
NA
|
