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Sample Record for 2023-03-21-1

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 993580 DEA: 020H5704 EFIS: 0215000052 QA Service Level: 1
DIST-CO-RTE-PM: 02-MOD-139-R3.5/30.3
Work Description: MODOC 139 DRAINAGE - DRAINAGE REHABILITATION
Location Description: IN MODOC COUNTY AT VARIOUS LOCATIONS FROM 1.2 MILES NORTH OF HOWARDS GULCH BRIDGE TO 0.1 MILE SOUTH OF CLEAR LAKE ROAD.
Contractor Name: JF SHEA CONSTRUCTION INC
Contractor Address: P.O. BOX 494519, REDDING, CA 96049
Resident Engineer: Joel Gasik Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2023-03-21-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Department Acceptance
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 03/21/2023
Date that the sample was received by the laboratory/organization performing the testing: 03/21/2023
The quantity of what the sample constitutes: 5518lbs
A brief description of the sample: A775 #4 Rebar
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Precast Unlimited

Material Information

Rebar Heat Number(s): 020423
Rebar Epoxy Batch Number(s): CH2142AP
Rebar Coating Specification: ASTM A775
Rebar Size (#): 4
Rebar Coating Color: Green
Rebar Manufacturer: Cascade
Rebar Coater: Western Coating Auburn WA
Rebar Powder Manufacturer: Sherwin Williams
Release Number: 1741
Quality Assurance Code:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2023-03-21-1-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 03/23/2023
Date Tested: 03/23/2023
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:
Test Result Compliance:
Additional Comments When Verified:
First Bar Mean 8.11
Second Bar Mean 8.43
Lower spec. limit LSL 7
Upper spec. limit USL 12
Bar # for First Bar 1
Bar # for Second Bar 2
Total mean value 8.27
Total number of values less than LSL no data
Total number of values greater than USL no data

Test 2 of 2

DIME Test ID: 2023-03-21-1-2
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 03/23/2023
Date Tested: 03/23/2023
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:
Test Result Compliance:
Additional Comments When Verified:
Total Number of Holiday no data0
Total Length 5
Holidays Per Linear Foot of Bar no data0 holiday per ft
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass