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Sample Record for 2018-09-20-2

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

Project Information

Project ID: 212743 DEA: 030H26U4 EFIS: 0317000247 QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-65-R5.0/R6.6
Work Description: NORTHBOUND WIDENING AND RAMP IMPROVEMENTS.
Location Description: PLACER COUNTY IN AND NEAR ROSEVILLE AND ROCKLIN FROM 0.1 MILE SOUTH OF EAST ROSEVILLE VIADUCT TO 0.5 MILE SOUTH OF PLEASANT GROVE BOULEVARD OVERCROSSING
Contractor Name: FLATIRON WEST INC
Contractor Address: 2100 Goodyear Rd, Benicia, CA 94510
Resident Engineer: Jeff Johnson Structure Rep.: James "Jimmer" Ross

Sample Information

DIME Sample ID: 2018-09-20-2
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT - Unassigned/General Field Laboratory
Sample Organization Contact: 5625005861
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 09/20/2018
Date that the sample was received by the laboratory/organization performing the testing: 09/20/2018
The quantity of what the sample constitutes: 2
A brief description of the sample: HRC 120 End Anchors
From where was the sample collected: Source
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: HRC

Material Information

Production or Authorization Testing: Production Testing
Rebar Heat Number(s): xxxx
Head Manufacturer Lot Number(s): xxxx
Rebar Size: 5
Headed Bar Model Name: HRC 120
Size of Head: Reduced Size - 4x
Head Connection Type: Friction Weld
Head Shape: Circular
Rebar Manufacturer: xxxxx
Head Manufacturer: HRC
Head Fabricator: HRC
Material Standard Code: ASTM A706
Headed Bar Unique ID:

Test Results

Test 1 of 3

DIME Test ID: 2018-09-20-2-1
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 10/09/2018
Date Tested: 10/09/2018
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: Bar Broke; OK Necking
Test Result Compliance:
Additional Comments When Verified:
Number of Headed Bar Samples 1
Lot #Area (sqin)Peak Load (lbf)Tensile Strength (psi)CommentsTested By
10.312972095870Bar BrokeBrian
Temperature 72 F
UTM 400KIP

Test 2 of 3

DIME Test ID: 2018-09-20-2-2
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 10/09/2018
Date Tested: 10/09/2018
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: Bar Broke; OK Necking
Test Result Compliance:
Additional Comments When Verified:
Number of Headed Bar Samples 1
Lot #Area (sqin)Peak Load (lbf)Tensile Strength (psi)CommentsTested By
10.312979096100Bar BrokeBrian
Temperature 72 F
UTM 400KIP

Test 3 of 3

DIME Test ID: 2018-09-20-2-3
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 10/09/2018
Date Tested: 10/09/2018
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: Bar Broke; OK Necking
Test Result Compliance:
Additional Comments When Verified:
Number of Headed Bar Samples 1
Lot #Area (sqin)Peak Load (lbf)Tensile Strength (psi)CommentsTested By
10.312977096030Bar BrokeBrian
Temperature 72 F
UTM 400KIP