Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002077 DEA: 033H5904 EFIS: 0318000017
QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-80-R26.3/R55.2
Work Description:
Location Description:
Contractor Name: Flatiron Dragados/Teichert
Contractor Address: 555 S Auburn St, Colfax, CA 95713
Resident Engineer: John Ruzic Structure Rep.: Carl Anderson
DIME Sample ID: 2026-08-04-4
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: 08/04/2026
Date that the sample was received by the laboratory/organization performing the testing: 08/18/2026
The quantity of what the sample constitutes: 48 pcs.
A brief description of the sample: #11 rebar with HRC 120 T-Head
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Headed Reinforcement Corporation (HRC)
Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 9013302
Head Manufacturer Lot Number(s): 100013306541
Rebar Size: #11
Headed Bar Model Name: HRC Type 120
Size of Head: Full Size - 9x
Head Connection Type: Friction Weld
Head Shape: Square
Rebar Manufacturer: CMC Steel Arizona
Head Manufacturer: Nucor
Head Fabricator: Headed Reinforcement Corp
Material Standard Code: ASTM A706
Headed Bar Unique ID: 9FW-17-03
DIME Test ID: 2026-08-04-4-1
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 08/20/2026
Date Tested: 08/20/2026
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:
|
Number of Headed Bar Samples
|
4
|
| Lot # | Area (sqin) | Peak Load (lbf) | Tensile Strength (psi) | Comments | Tested By | | 1 | 1.56 | 137270 | 88000 | NA | Atlas | | 1 | 1.56 | 140090 | 89800 | NA | Atlas | | 1 | 1.56 | 137750 | 88300 | NA | Atlas | | 1 | 1.56 | 138230 | 88600 | NA | Atlas |
| |
|
Temperature
|
0 f
|
|
UTM
|
NA
|
