Sample Record for 2026-02-04-23
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000004 DEA: 033H5604 EFIS: 0318000014
QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA,NEV-20,80-VAR
Work Description: STRUCTURAL CONC, BAR REINFORCING STEEL, BRIDGE REMOVAL, HMA, AND JPCP.
Location Description: PLACER AND NEVADA COUNTIES NEAR CISCO GROVE ON ROUTE 80 FROM 0.4 MILE WEST OF LAKE VALLEY OVERCROSSING TO 0.9 MILE EAST OF YUBA PASS SEPARATION AND OVERHEAD AND ON ROUTE 20 AT YUBA PASS SEPARATION AND OVERHEAD
Contractor Name: FLATIRON WEST INC.
Contractor Address: 1200 Concord Ave Suite 465, Concord, CA 94520
Resident Engineer: Tad Sampson Structure Rep.: James 'Jimmer' Ross
Sample Information
DIME Sample ID: 2026-02-04-23
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: Quality Assurance
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 02/04/2026
Date that the sample was received by the laboratory/organization performing the testing: 02/04/2026
The quantity of what the sample constitutes: Rebar Couplers
A brief description of the sample: 4 EA Couplers
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: C&N
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: C&N
Coupler Manufacturer: HRC
Intermediate Assembler or Fabricator:
Rebar Size: #11
Coupler Model: 500/510
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): 74135330, 73135166
Rebar Heat Number(s): 6034212
Rebar Size 2 :
Coupler Unique ID: TP-17-03
Test Results
Test 1 of 1
DIME Test ID: 2026-02-04-23-1
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 02/17/2026
Date Tested: 02/17/2026
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: 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 | 6034212 | 11 | 1.56 | 0.0059 | 162220 | 103987 | NA | Atlas | | 2 | 6034212 | 11 | 1.56 | 0 | 159930 | 102519 | NA | Atlas | | 3 | 6034212 | 11 | 1.56 | 0 | 160720 | 103026 | NA | Atlas | | 4 | 6034212 | 11 | 1.56 | 0 | 159720 | 102385 | NA | Atlas |
| |
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Temperature
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0 f
|
|
UTM
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NA
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Halo ID
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NA
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