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Sample Record for 2023-10-17-1

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Project Information

Project ID: 994751 DEA: 010C5004 EFIS: 0112000292 QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-36-11.3/34.6
Work Description: Project Name: Bridge Rail Replacement - 3 Bridges
Location Description: Hely Creek, Little Larabee Creek and Butte Creek Bridge.
Contractor Name: Mercer-Fraser Company
Contractor Address: 200 Dinsmore Dr, Fortuna, CA 95540
Resident Engineer: Joaquin Rodriguez Structure Rep.: Shantanu Nalawade

Sample Information

DIME Sample ID: 2023-10-17-1
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 - Headed Bars
Sample Taken Date: 10/17/2023
Date that the sample was received by the laboratory/organization performing the testing: 10/25/2023
The quantity of what the sample constitutes: 1 Lot
A brief description of the sample: #11 HRC 555
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Steel Group

Material Information

Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 3500030480
Head Manufacturer Lot Number(s): Lot 1
Rebar Size: #11
Headed Bar Model Name: HRC 555
Size of Head: Reduced Size - 4x
Head Connection Type:
Head Shape: Circular
Rebar Manufacturer: Nucor
Head Manufacturer: Pacific Steel Group
Head Fabricator: Pacific Steel Group
Material Standard Code: ASTM A706
Headed Bar Unique ID: 4FG-17-01
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2023-10-17-1-1
Test Method: ASTM A970-18: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 10/26/2023
Date Tested: 10/26/2023
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: 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
11.5614795494843Ok Neckingrmacias
Temperature 72 f
UTM 400kip

Test 2 of 3

DIME Test ID: 2023-10-17-1-2
Test Method: ASTM A970-18: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 10/26/2023
Date Tested: 10/26/2023
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: 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
11.5614528993134Ok Neckingrmacias
Temperature 72 f
UTM 400kip

Test 3 of 3

DIME Test ID: 2023-10-17-1-3
Test Method: ASTM A970-18: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 10/26/2023
Date Tested: 10/26/2023
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: 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
11.5614538493195Ok Neckingrmacias
Temperature 72 f
UTM 400kip