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Sample Record for 2018-05-29-5

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

Project Information

Project ID: 210808 DEA: 020E0904 EFIS: 0200000016 QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA-5-R29.3/R31.1,R45.0/R45.8
Work Description: REPLACE BRIDGE, REALIGN ROADWAY AND SEISMIC RETROFIT
Location Description: IN SHASTA COUNTY ABT 8 MI N OF SHASTA LAKE CTY AND NEAR LAKEHEAD FRM TURNTABLE BAY O/C TO 0.1 MI N OF O'BRIEN SRRA & FRM 0.4 MI S TO 0.3 MI N OF DOG CREEK BRIDGE.
Contractor Name: GOLDEN STATE BRIDGE, INC.
Contractor Address: 3701 Mallard Drive, Benicia, CA 94510
Resident Engineer: Nathan Alexander Structure Rep.: Christopher S 'Chris' Brace

Sample Information

DIME Sample ID: 2018-05-29-5
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 TM7 - Epoxy Coated Rebar
Sample Taken Date: 05/29/2018
Date that the sample was received by the laboratory/organization performing the testing: 05/29/2018
The quantity of what the sample constitutes: Lot 1
A brief description of the sample: A934 Expoxy Rebar
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Fletcher Coating Co

Material Information

Rebar Heat Number(s): PL17108331
Rebar Epoxy Batch Number(s): 8A25B179 8A26A173
Rebar Coating Specification: ASTM A934
Rebar Size (#): 11
Rebar Coating Color: Purple
Rebar Manufacturer: Nucor
Rebar Coater: C180167,C180167
Rebar Powder Manufacturer: Fletcher Coating Company
Release Number: Unknown
Quality Assurance Code: Unknown

Test Results

Test 1 of 2

DIME Test ID: 2018-05-29-5-1
Test Method: ASTM A934-13: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Epoxy-Coating)
Verified Date: 06/11/2018
Date Tested: 06/07/2018
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 7 mils
Upper spec. limit USL 12 mils
Bar # for First Bar 11
Bar # for Second Bar 11
First Bar Mean 9.94
Second Bar Mean 10.07
Total mean value 10.01

Test 2 of 2

DIME Test ID: 2018-05-29-5-2
Test Method: ASTM A934-13: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Holiday Bend)
Verified Date: 06/11/2018
Date Tested: 06/07/2018
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:
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