Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 88888 DEA: SMTL-STOCK EFIS: SMTL-STOCK
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for SMTL stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2024-03-26-67
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (530) 329-6527
Type of Sample: Authorization
Type of Material: SMTL TM5 - Threaded Bar
Sample Taken Date: 03/26/2024
Date that the sample was received by the laboratory/organization performing the testing: 04/02/2024
The quantity of what the sample constitutes: 6
A brief description of the sample: 1.75" A722 Type II Threaded Bar
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Williams Form
Production or Authorization Testing: Authorization Testing
Threaded Bar Specification: ASTM A722
Threaded Bar Grade: 150
Threaded Bar Type: Deformed
Rebar Size:
Nut Specification for Threaded Bar: A29
System Manufacturer: Williams Form
Epoxy Coating Color: NA
Threaded Bar Application:
Coating Standards: Uncoated
Bar Heat Number(s): 100891963
Nut Heat Number(s): 79008719
Bar Lot Number:
Nut Lot Number:
Coupler Heat Number(s): 100104123
Coupler Grade:
DIME Test ID: 2024-03-26-67-1
Test Method: ASTM A722-18: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
Verified Date: 10/08/2025
Date Tested: 09/26/2025
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:
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Number of Threaded Bar Samples
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6
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| Sample | Size | Mfg Lot | Area (sqin) | Tensile Strength (psi) | Stress at Offset (psi) | Total Elongation (%) | Reduction of area (%) | Comments | Tested By | | 1 | 1 3/4 | 100891963 | 2.58 | 154800 | 127000 | 0 | 0 | NA | Miguel Baltazar | | 2 | 1 3/4 | 100891963 | 2.58 | 155500 | 128100 | 0 | 0 | NA | Miguel Baltazar | | 3 | 1 3/4 | 100891963 | 2.58 | 156200 | 128100 | 0 | 0 | NA | Miguel Baltazar | | 4 | 1 3/4 | 100891963 | 2.58 | 155800 | 128100 | 0 | 0 | NA | Miguel Baltazar | | 5 | 1 3/4 | 100891963 | 2.37 | 155000 | 137100 | 12 | 42 | NA | Miguel Baltazar | | 6 | 1 3/4 | 100891963 | 2.58 | 154600 | 128100 | 10 | 0 | NA | Miguel Baltazar |
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Temperature
|
0 f
|
|
UTM
|
NA
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