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Sample Record for 2017-10-13-1

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

Project Information

Project ID: 210196 DEA: 100P9224 EFIS: 1014000079 QA Service Level: 1
DIST-CO-RTE-PM: 10-MPA-140-42.0/42.7
Work Description: Ferguson Slide Talus Removal (Phase 1). NOTIFY SMR BEFORE RESPONDING TO ANY TESTING OR SOURCE INSPECTION REQUESTS. Caltrans is the Implementing Agency. CMGC Project. Phase 2 (EA 10-0P9214) to begin in 2016. PROJECT ON HOLD PENDING FURTHER STUDY; 4/01/2016
Location Description: In Mariposa, Mariposa County, on State Route 140 near El Portal Road Bridge to 0.5 miles W of South Fork Merced River Bridge. Ferguson Slide.
Contractor Name: Myers and Sons / RL Wadsworth JV
Contractor Address: 4600 Northgate Blvd, Ste 100, Sacramento, CA 95834
Resident Engineer: Corey Casey Structure Rep.: Ramandeep S Guraya

Sample Information

DIME Sample ID: 2017-10-13-1
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Threaded Bar
Sample Taken Date: 10/13/2017
Date that the sample was received by the laboratory/organization performing the testing: 10/18/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: threaded bar, nuts, coupler
From where was the sample collected: Distributor
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: DSI

Material Information

Production or Authorization Testing: Production Testing
Threaded Bar Specification: ASTM A722
Threaded Bar Grade: 150
Threaded Bar Type: Plain
Rebar Size: 3in
Nut Specification for Threaded Bar: N/A
System Manufacturer: DSI
Epoxy Coating Color: NA
Threaded Bar Application: Threaded Bar
Coating Standards: Uncoated
Bar Heat Number(s): NF15202008
Nut Heat Number(s): 155585
Bar Lot Number: 11563
Nut Lot Number: N/A
Coupler Heat Number(s): L1085
Coupler Grade: 1026
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2017-10-13-1-1
Test Method: ASTM A722-15: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
Verified Date: 10/19/2017
Date Tested: 10/19/2017
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: A722
Test Result Compliance:
Additional Comments When Verified:
Number of Threaded Bar Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)Reduction of area (%)CommentsTested By
1A722 3\" x 84 Threaed Bar w/ Nuts & CouplerBar NF15202008, Nut Heat #155585-N, Coupler Heat #L10856.8516108013983330A722Fred
Temperature 72 F
UTM 2000KIP

Test 2 of 2

DIME Test ID: 2017-10-13-1-2
Test Method: ASTM A722-15: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
Verified Date: 10/19/2017
Date Tested: 10/19/2017
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: A722
Test Result Compliance:
Additional Comments When Verified:
Number of Threaded Bar Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)Reduction of area (%)CommentsTested By
2A722 3\" x 84 Threaed Bar w/ Nuts Bar NF15202008, Nut Heat #155585-N,6.237165340150673438A722Fred
Temperature 72 F
UTM 2000KIP