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Sample Record for 2017-08-01-4

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

Project Information

Project ID: 208682 DEA: 083401U4 EFIS: 0800000609 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-138,138-6.2/6.4,2.3/R15.2
Work Description: WIDEN TO 4 LNS FR BEEKLEY RD TO JCT 15, ADD 1 LN EB FR PHELAN RD TO
Location Description: SAN BERNARDINO COUNTY ON ROUTE 138 NEAR PHELAN FROM 0.6 MILE WEST OF PHELAN ROAD TO THE JUNCTION OF ROUTE 15 AND ON ROUTE 2 FROM 0.1 MILE NORTH OF WILD HORSE CANYON ROAD TO ROUTE 138
Contractor Name: Flatiron
Contractor Address: 1770 LA COSTA MEADOWS DRIVE, SAN MARCOS CA 92078
Resident Engineer: Elvira Lenart Structure Rep.: Osama Abdalla

Sample Information

DIME Sample ID: 2017-08-01-4
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Verification
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 08/01/2017
Date that the sample was received by the laboratory/organization performing the testing: 08/02/2017
The quantity of what the sample constitutes: 1 truck load
A brief description of the sample: 5, 6, 8, A775 epoxy coated rebar
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Western Coating

Material Information

Rebar Heat Number(s): 4065349, PL17205214, PL17103455, PL17203474
Rebar Epoxy Batch Number(s): 7696024903, TD95852NA
Rebar Coating Specification: ASTM A775
Rebar Size (#): 5, 6, 8
Rebar Coating Color: Green
Rebar Manufacturer: CMC,Nucor
Rebar Coater: Western Coating
Rebar Powder Manufacturer: Valspar,Axalta
Release Number: 36368
Quality Assurance Code: Unknown
Test results on following page(s): 6

Test Results

Test 1 of 6

DIME Test ID: 2017-08-01-4-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 08/07/2017
Date Tested: 08/04/2017
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: #5 Rebar
Test Result Compliance:
Additional Comments When Verified:
First Bar Mean 11.35 mils
Second Bar Mean 11.86 mils
Lower spec. limit LSL 7 mils
Upper spec. limit USL 12 mils
Bar # for First Bar no data
Bar # for Second Bar no data
Total mean value 11.6 mils
Total number of values less than LSL no data
Total number of values greater than USL no data

Test 2 of 6

DIME Test ID: 2017-08-01-4-2
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 08/07/2017
Date Tested: 08/04/2017
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: #5 Rebar
Test Result Compliance:
Additional Comments When Verified:
Total Number of Holiday 0
Total Length 5 ft
Holidays Per Linear Foot of Bar 0 holiday pe
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass

Test 3 of 6

DIME Test ID: 2017-08-01-4-3
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 08/07/2017
Date Tested: 08/04/2017
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: #6 Rebar
Test Result Compliance:
Additional Comments When Verified:
First Bar Mean 8.52 mils
Second Bar Mean 8.97 mils
Lower spec. limit LSL 7 mils
Upper spec. limit USL 16 mils
Bar # for First Bar no data
Bar # for Second Bar no data
Total mean value 8.74 mils
Total number of values less than LSL no data
Total number of values greater than USL no data

Test 4 of 6

DIME Test ID: 2017-08-01-4-4
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 08/07/2017
Date Tested: 08/04/2017
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: #6 Rebar
Test Result Compliance:
Additional Comments When Verified:
Total Number of Holiday 3
Total Length 5 ft
Holidays Per Linear Foot of Bar 0.6 holiday pe
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass

Test 5 of 6

DIME Test ID: 2017-08-01-4-5
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 08/07/2017
Date Tested: 08/04/2017
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: #8 Rebar
Test Result Compliance:
Additional Comments When Verified:
First Bar Mean 9.56 mils
Second Bar Mean 9.49 mils
Lower spec. limit LSL 7 mils
Upper spec. limit USL 16 mils
Bar # for First Bar no data
Bar # for Second Bar no data
Total mean value 9.52 mils
Total number of values less than LSL no data
Total number of values greater than USL no data

Test 6 of 6

DIME Test ID: 2017-08-01-4-6
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 08/07/2017
Date Tested: 08/04/2017
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: #8 Rebar
Test Result Compliance:
Additional Comments When Verified:
Total Number of Holiday 2
Total Length 5 ft
Holidays Per Linear Foot of Bar 0.4 holiday pe
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass