Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000409 DEA: 051S1604 EFIS: 0524000176
QA Service Level: 1
DIST-CO-RTE-PM: 05-MON-1-60
Work Description: Rocky Creek Slip Out Permanent Restoration Project
Location Description:
Contractor Name: Gordon N Ball, Inc. (Fred Velasco/Stuart Yamamoto)
Contractor Address: 333 Camille Avenue, Alamo, CA 94507
Resident Engineer: Jorge Uberhuaga Structure Rep.: Daniel Dait
DIME Sample ID: 2024-09-03-7
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 TM4 - Prestressing Strand
Sample Taken Date: 09/03/2024
Date that the sample was received by the laboratory/organization performing the testing: 09/09/2024
The quantity of what the sample constitutes: 1 spool
A brief description of the sample: 4 EA 5ft long epoxy coated strand samples from each spool per SS Section 50-1.01C(5)
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name: Rocky Creek
The fabricator/manufacturer/facility name: Sumiden Wire
Comments:
Reel/Coil/Pack Number(s): T350131-1-1
Number of Coils: 7
Group Number:
Strand Diameter: .6 in
Grade: 270
Strand Specification: ASTM A 416
Heat Number(s): T1366459
Mfg. Lot Number(s): T350131-1-1
Manufacturer(s): Sumiden Wire
DIME Test ID: 2024-09-03-7-2
Test Method: ASTM A882-20: Standard Specification for Filled Epoxy-Coated Seven-Wire Prestressing Steel Strand (Withdrawn 2019) (Coating Adhesion)
Verified Date: 09/13/2024
Date Tested: 09/12/2024
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: complies
Additional Comments When Verified:
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Coating Adhesion Pass/Fail
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Pass
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