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Sample Record for 2021-11-30-1

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Project Information

Project ID: 215255 DEA: 040A7714 EFIS: 0420000287 QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-80-6.4-6.6
Work Description: CONSTRUCT PEDESTRIAN OVERCROSSING BRIDGE AND RETAINING WALLS. GILMAN INTERCHANGE IMPROVEMENTS
Location Description: ALAMEDA COUNTY IN BERKELEY FROM 0.6 MILE NORTH OF UNIVERSITY AVENUE OVERCROSSING TO 0.1 MILE SOUTH OF GILMAN STREET UNDERCROSSING
Contractor Name: Golden State Bridge
Contractor Address: 3701 Mallard Drive, Benicia, CA 94510
Resident Engineer: Rebecca Perng Structure Rep.: Eric Urmeneta

Sample Information

DIME Sample ID: 2021-11-30-1
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: 11/30/2021
Date that the sample was received by the laboratory/organization performing the testing: 12/07/2021
The quantity of what the sample constitutes: (11) #5 HRC 120 X 18'-0"
A brief description of the sample: (4) #5 HRC 120 X 18'-0"
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: HRC Fountain Valley

Material Information

Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 4111735
Head Manufacturer Lot Number(s): LOT 1
Rebar Size: #5
Headed Bar Model Name: HRC 120 9FW 17 03
Size of Head: Full Size - 9x
Head Connection Type: Friction Weld
Head Shape: Square
Rebar Manufacturer: CMC Rebar
Head Manufacturer: NUCOR HRC HEAT NO 10021114224
Head Fabricator: HRC
Material Standard Code: ASTM A706
Headed Bar Unique ID:

Test Results

Test 1 of 3

DIME Test ID: 2021-11-30-1-1
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 12/09/2021
Date Tested: 12/08/2021
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: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test: ok necking
Test Result Compliance:
Additional Comments When Verified:
Number of Headed Bar Samples 1
Lot #Area (sqin)Peak Load (lbf)Tensile Strength (psi)CommentsTested By
10.312974595951ok neckingspaine
Temperature 72 f
UTM 400kip

Test 2 of 3

DIME Test ID: 2021-11-30-1-2
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 12/09/2021
Date Tested: 12/08/2021
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: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test: ok necking
Test Result Compliance:
Additional Comments When Verified:
Number of Headed Bar Samples 1
Lot #Area (sqin)Peak Load (lbf)Tensile Strength (psi)CommentsTested By
10.312973095905ok neckingspaine
Temperature 72 f
UTM 400kip

Test 3 of 3

DIME Test ID: 2021-11-30-1-3
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 12/09/2021
Date Tested: 12/08/2021
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: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test: ok necking
Test Result Compliance:
Additional Comments When Verified:
Number of Headed Bar Samples 1
Lot #Area (sqin)Peak Load (lbf)Tensile Strength (psi)CommentsTested By
10.312954795312ok neckingspaine
Temperature 72 f
UTM 400kip