Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001678 DEA: 101U5604 EFIS: 1025000204
QA Service Level: 1
DIST-CO-RTE-PM: 10---
Work Description: Replacement of Box Girder
Location Description:
Contractor Name: Golden State Bridge
Contractor Address: 3701 Mallard Drive, Benicia, CA 94510
Resident Engineer: Chris Hanson Structure Rep.: Unknown
DIME Sample ID: 2026-04-14-11
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: 04/14/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/14/2026
The quantity of what the sample constitutes: 8
A brief description of the sample: #5 Zap Screwlok Couplers
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Site
Production or Authorization Testing: Production Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: CMC
Coupler Manufacturer: Bar Splice
Intermediate Assembler or Fabricator:
Rebar Size: #5
Coupler Model: Zap ScrewLok SL
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): 4000032113
Rebar Heat Number(s): 4149839
Rebar Size 2 :
Coupler Unique ID: SL-21-02
DIME Test ID: 2026-04-14-11-1
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 04/28/2026
Date Tested: 04/22/2026
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:
|
Number of Samples
|
4
|
| Sample | Mfg. Lot Number(s) | Size | Area (sqin) | Slip (inch) | Peak Load (lbf) | Peak Stress (psi) | Comments | Tested By | | 1 | 1 | 5 | 0.31 | 0.0020 | 28570 | 92161 | NA | Atlas | | 2 | 1 | 5 | 0.31 | 0 | 27470 | 88613 | NA | Atlas | | 3 | 1 | 5 | 0.31 | 0 | 27460 | 88581 | NA | Atlas | | 4 | 1 | 5 | 0.31 | 0 | 28270 | 91194 | NA | Atlas |
| |
|
Temperature
|
0 f
|
|
UTM
|
NA
|
|
Halo ID
|
NA
|
DIME Test ID: 2026-04-14-11-2
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 04/28/2026
Date Tested: 04/22/2026
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:
|
Number of Samples
|
4
|
| Sample | Mfg. Lot Number(s) | Size | Area (sqin) | Slip (inch) | Peak Load (lbf) | Peak Stress (psi) | Comments | Tested By | | 1 | 2 | 5 | 0.31 | 0.0077 | 28060 | 90516 | NA | Atlas | | 2 | 2 | 5 | 0.31 | 0 | 27220 | 87806 | NA | Atlas | | 3 | 2 | 5 | 0.31 | 0 | 27330 | 88161 | NA | Atlas | | 4 | 2 | 5 | 0.31 | 0 | 26970 | 87000 | NA | Atlas |
| |
|
Temperature
|
0 f
|
|
UTM
|
NA
|
|
Halo ID
|
NA
|
