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Sample Record for 2017-10-04-12

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

Project Information

Project ID: 212363 DEA: 07333404 EFIS: 0716000306 QA Service Level: 1
DIST-CO-RTE-PM: 07---
Work Description:
Location Description:
Contractor Name: C. A. RASMUSSEN, INC.
Contractor Address: 28548 LIVINGSTON AVENUE, VALENCIA CA 91355
Resident Engineer: James Riley Structure Rep.: Frank Lotfi

Sample Information

DIME Sample ID: 2017-10-04-12
TL Number from the TL Form: C939422
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: 10/04/2017
Date that the sample was received by the laboratory/organization performing the testing: 10/16/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: Epoxy Coated Rebar
From where was the sample collected: Job Site
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC Rebar Commercial Metals

Material Information

Rebar Heat Number(s): 4066938, 4068245
Rebar Epoxy Batch Number(s):
Rebar Coating Specification: ASTM A775
Rebar Size (#): 4, 5
Rebar Coating Color: Green
Rebar Manufacturer: CMC Rebar
Rebar Coater: Commercial Metals
Rebar Powder Manufacturer: Unknown
Release Number: Unknown
Quality Assurance Code: Unknown
Test results on following page(s): 4

Test Results

Test 1 of 4

DIME Test ID: 2017-10-04-12-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 10/18/2017
Date Tested: 10/18/2017
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: #4/13
Test Result Compliance:
Additional Comments When Verified:
First Bar Mean 10.78 mils
Second Bar Mean 10.72 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 10.75 mils
Total number of values less than LSL no data
Total number of values greater than USL no data

Test 2 of 4

DIME Test ID: 2017-10-04-12-2
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 10/18/2017
Date Tested: 10/18/2017
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: #4/13
Test Result Compliance:
Additional Comments When Verified:
Total Number of Holiday 0
Total Length 2.6
Holidays Per Linear Foot of Bar 0
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass

Test 3 of 4

DIME Test ID: 2017-10-04-12-3
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 10/18/2017
Date Tested: 10/18/2017
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: #5/16
Test Result Compliance:
Additional Comments When Verified:
First Bar Mean 7.56
Second Bar Mean 7.17
Lower spec. limit LSL 7
Upper spec. limit USL 12
Bar # for First Bar no data
Bar # for Second Bar no data
Total mean value 7.36
Total number of values less than LSL no data
Total number of values greater than USL no data

Test 4 of 4

DIME Test ID: 2017-10-04-12-4
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 10/18/2017
Date Tested: 10/18/2017
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: #5/16
Test Result Compliance:
Additional Comments When Verified:
Total Number of Holiday 0
Total Length 2.6
Holidays Per Linear Foot of Bar 0
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass