Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
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
DIME Sample ID: 2026-01-16-1
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 - Headed Bars
Sample Taken Date: 01/16/2026
Date that the sample was received by the laboratory/organization performing the testing: 01/22/2026
The quantity of what the sample constitutes: 150
A brief description of the sample: #7 HRC 120
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Headed Reinforcement Corp, Fountain Valley, CA
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 387625
Head Manufacturer Lot Number(s): 100012457343
Rebar Size: #7
Headed Bar Model Name: HRC 120
Size of Head: Full Size - 9x
Head Connection Type:
Head Shape: Square
Rebar Manufacturer: Cascade Steel
Head Manufacturer: Nucor
Head Fabricator: HRC Fountain Valley
Material Standard Code: ASTM A706
Headed Bar Unique ID: 9FW-17-03
DIME Test ID: 2026-01-16-1-1
Test Method: ASTM A970-18: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 02/02/2026
Date Tested: 01/30/2026
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 Headed Bar Samples
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4
|
| Lot # | Area (sqin) | Peak Load (lbf) | Tensile Strength (psi) | Comments | Tested By | | 1 | 0.60 | 59100 | 98500 | Ok Necking | Kleinfelder | | 1 | 0.60 | 58430 | 97500 | Ok Necking | Kleinfelder | | 1 | 0.60 | 59750 | 99500 | Ok Necking | Kleinfelder | | 1 | 0.60 | 59830 | 99500 | Ok Necking | Kleinfelder |
| |
|
Temperature
|
0 f
|
|
UTM
|
NA
|
