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Sample Record for 2017-01-12-1

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

Project Information

Project ID: 3825 DEA: 07138204 EFIS: 0700000142 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-47,103-3.5/4.6,0.0/1.1
Work Description: REPLACE STEEL BRIDGE WITH CIP PS CONCRETE BOX GIRDER BRIDGE AND RAMPS.
Location Description: LOS ANGELES COUNTY IN LONG BEACH AND LOS ANGELES ON ROUTE 47 FROM OCEAN BOULEVARD TO ROUTE 103 JUNCTION AND ON ROUTE 103 FROM ROUTE 47 JUNCTION TO ANAHEIM STREET OVERHEAD
Contractor Name: M C M CONSTRUCTION INC
Contractor Address: P O BOX 620, NORTH HIGHLANDS, CA 95660
Resident Engineer: Daniel Leon Structure Rep.: Andy Chen

Sample Information

DIME Sample ID: 2017-01-12-1
TL Number from the TL Form: C953676
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (530) 329-6527
Type of Sample: Quality Assurance
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 01/12/2017
Date that the sample was received by the laboratory/organization performing the testing: 01/17/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: Epoxy Coated Rebar
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC Rebar Fletcher

Material Information

Rebar Heat Number(s): 4062123
Rebar Epoxy Batch Number(s): 6H02
Rebar Coating Specification: ASTM A934
Rebar Size (#): #5
Rebar Coating Color: Purple
Rebar Manufacturer: CMC Rebar
Rebar Coater: Fletcher Coating Company
Rebar Powder Manufacturer: 3M
Release Number: Unknown
Quality Assurance Code: Unknown
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2017-01-12-1-1
Test Method: ASTM A934-13: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Epoxy-Coating)
Verified Date: 01/19/2017
Date Tested: 01/17/2017
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: complies
Additional Comments When Verified:
Lower spec. limit LSL 7 mils
Upper spec. limit USL 12 mils
Bar # for First Bar 1
Bar # for Second Bar 2
First Bar Mean 9.15 mils
Second Bar Mean 10 mils
Total mean value 9.57 mils

Test 2 of 2

DIME Test ID: 2017-01-12-1-2
Test Method: ASTM A934-13: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Holiday Bend)
Verified Date: 01/19/2017
Date Tested: 01/17/2017
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: complies
Additional Comments When Verified:
Total Number of Holiday 0
Total Length 2.5 ft
Holidays Per Linear Foot of Bar 0 holiday pe
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass