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Sample Record for 2017-01-24-4

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

Project Information

Project ID: 210696 DEA: 080M2804 EFIS: 0800000472 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-171.8/173.8
Work Description: BRIDGE REPLACEMENT AND WIDEN, CONC AND HMA PVMT, COLD PLANE AC PVMT.
Location Description: In SBD County
Contractor Name: M.C.M. CONSTRUCTION, INC. - Dan Shaw
Contractor Address: P.O. Box 620, North Highlands, CA 95660
Resident Engineer: John Santos Structure Rep.: Faisal Zahlout

Sample Information

DIME Sample ID: 2017-01-24-4
TL Number from the TL Form: C015
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 TM5 - Couplers
Sample Taken Date: 01/24/2017
Date that the sample was received by the laboratory/organization performing the testing: 01/27/2017
The quantity of what the sample constitutes: 4
A brief description of the sample: Lenton Couplers
From where was the sample collected: Job Site
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Nucor Erico

Material Information

Production or Authorization Testing: Authorization Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Nucor
Coupler Manufacturer: Erico
Intermediate Assembler or Fabricator: Unknown
Rebar Size: 5
Coupler Model: Lenton Form Saver
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter: Unknown
Rebar Hoop Fabricator: Unknown
Coupler Component Heat/Lot Number(s): L8923
Rebar Heat Number(s): PL16208724 PL16108669
Rebar Size 2 :
Coupler Unique ID:

Test Results

Test 1 of 3

DIME Test ID: 2017-01-24-4-1
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 01/30/2017
Date Tested: 01/30/2017
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: Service Splice
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleMfg. Lot Number(s)SizeArea (sqin)Slip (inch)Peak Load (lbf)Peak Stress (psi)CommentsTested By
11#5/16mm0.31-0.00022895793410Service SpliceBrian
Temperature 71 F
UTM 75KIP
Halo ID Small

Test 2 of 3

DIME Test ID: 2017-01-24-4-2
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 01/30/2017
Date Tested: 01/30/2017
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: Service Splice
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleMfg. Lot Number(s)SizeArea (sqin)Slip (inch)Peak Load (lbf)Peak Stress (psi)CommentsTested By
21#5/16mm0.3102926694406Service SpliceBrian
Temperature 71 F
UTM 75KIP
Halo ID Small

Test 3 of 3

DIME Test ID: 2017-01-24-4-3
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 01/30/2017
Date Tested: 01/30/2017
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: Service Splice
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleMfg. Lot Number(s)SizeArea (sqin)Slip (inch)Peak Load (lbf)Peak Stress (psi)CommentsTested By
31#5/16mm0.3102967495723Service SpliceBrian
Temperature 71 F
UTM 75KIP
Halo ID Small