Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002029 DEA: 044X4604 EFIS: 0426000059
QA Service Level: 1
DIST-CO-RTE-PM: 04-SON--unknown
Work Description: ROADWAY SETTLEMENT REPAIR
Location Description:
Contractor Name: Terracon Constructors Inc
Contractor Address: 150 Alexander Valley Rd, Healdsburg, CA 95448 ยท
Resident Engineer: Harley Paulo Structure Rep.: ,Syd Valeh
DIME Sample ID: 2026-04-09-4
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Threaded Bar
Sample Taken Date: 04/09/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/21/2026
The quantity of what the sample constitutes: 29
A brief description of the sample: Threaded Rod w/Coupler & Nut
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Z Systems
Production or Authorization Testing: Authorization Testing
Threaded Bar Specification: ASTM A722
Threaded Bar Grade: 150
Threaded Bar Type: Plain
Rebar Size:
Nut Specification for Threaded Bar: A519 Gr. 150
System Manufacturer: Z Systems
Epoxy Coating Color: NA
Threaded Bar Application: Threaded Bar
Coating Standards: Uncoated
Bar Heat Number(s): 58063926
Nut Heat Number(s): C257132
Bar Lot Number:
Nut Lot Number:
Coupler Heat Number(s): C223276
Coupler Grade:
DIME Test ID: 2026-04-09-4-1
Test Method: ASTM A615-20: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 05/04/2026
Date Tested: 05/04/2026
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:
Additional Comments When Verified:
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Number of Samples
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4
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| Sample | Size | Mfg Lot | Area (sqin) | Tensile Strength (psi) | Stress at Offset (psi) | Total Elongation (%) | Comments | Tested By | | 1 | 1 | 58063926 | 0.85 | 153620 | 127180 | 0000 | A722 bar, nut, coupler | WSP | | 2 | 1 | 58063926 | 0.85 | 150740 | 121760 | 0000 | A722 bar and nut | WSP | | 3 | 1 | 58063926 | 0.85 | 149510 | 123260 | 0000 | A722 reduction of area | WSP | | 4 | 1 | 58063926 | 0.85 | 153390 | 127290 | 14 | A722 Elongation | WSP |
| |
|
Temperature
|
0 f
|
|
UTM
|
NA
|
