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Sample Record for 2017-10-20-4

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

Project Information

Project ID: 211931 DEA: 043G6414 EFIS: 0416000348 QA Service Level: 1
DIST-CO-RTE-PM: 04-NAP-29-37.0
Work Description: SCOUR REPLACE BRIDGE
Location Description: NAPA COUNTY IN CALISTOGA AT NAPA RIVER BRIDGE
Contractor Name: Valentine Corp.
Contractor Address: 111 Pelican Way, San Rafael, CA 94901
Resident Engineer: Danilo Patenia Structure Rep.: Nana Budu

Sample Information

DIME Sample ID: 2017-10-20-4
TL Number from the TL Form: C647235
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: 10/20/2017
Date that the sample was received by the laboratory/organization performing the testing: 10/20/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: A615 Grade 75 Threaded Bar
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Williams Form Engineering

Material Information

Production or Authorization Testing: Production Testing
Threaded Bar Specification: ASTM A615
Threaded Bar Grade: 75
Threaded Bar Type: Deformed
Rebar Size: 9
Nut Specification for Threaded Bar: 8290539
System Manufacturer: Williams Form Eng
Epoxy Coating Color: Purple
Threaded Bar Application:
Coating Standards: ASTM A934 epoxy
Bar Heat Number(s): 100786966
Nut Heat Number(s): 8290539
Bar Lot Number: Unknown
Nut Lot Number: 9H7D
Coupler Heat Number(s): NF10100614C
Coupler Grade: Unknown

Test Results

Test 1 of 3

DIME Test ID: 2017-10-20-4-2
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 10/26/2017
Date Tested: 10/25/2017
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: A615 Bar & Nut
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)CommentsTested By
1Williams Bar #9 Bar Heat #100786966, Nut HeaL730121711283819655810.6A615 Bar & NutFred
Temperature 72 F
UTM 400KIP

Test 2 of 3

DIME Test ID: 2017-10-20-4-3
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 10/26/2017
Date Tested: 10/25/2017
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: A615 Bar, Nut & coupler
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)CommentsTested By
2Williams Bar #9 Bar Heat #100786966, Nut HeaL73012171128660979200A615 Bar, Nut & couplerFred
Temperature 72 F
UTM 400KIP

Test 3 of 3

DIME Test ID: 2017-10-20-4-4
Test Method: ASTM A934-13: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Epoxy-Coating)
Verified Date: 10/26/2017
Date Tested: 10/25/2017
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:
Additional Comments When Verified:
Lower spec. limit LSL 10 mils
Upper spec. limit USL 15 mils
Bar # for First Bar 1
Bar # for Second Bar 2
First Bar Mean 10.23
Second Bar Mean 12.32
Total mean value 11.27