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Sample Record for 2018-09-20-3

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

Project Information

Project ID: 211778 DEA: 04235654 EFIS: 0400000680 QA Service Level: 1
DIST-CO-RTE-PM: 04-SM-101,114-1.3/2.5,5.0/5.3
Work Description: RECONSTRUCT INTERCHANGE
Location Description: SAN MATEO COUNTY AT VARIOUS LOCATIONS ON ROUTE 101 FROM 0.4 MILE NORTH OF UNIVERSITY AVENUE OVERCROSSING TO 0.6 MILE SOUTH OF HENDERSON UNDERPASS AND ON ROUTE 114 FROM WILLOW ROAD SEPARATION TO NEWBRIDGE STREET
Contractor Name: Disney/OC Jones Construction Company Inc.
Contractor Address: 533 Airport Blvd, Suite 120, Burlingame, CA 94010
Resident Engineer: Fernando Abela Structure Rep.: Oanh Bui

Sample Information

DIME Sample ID: 2018-09-20-3
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Control
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 09/20/2018
Date that the sample was received by the laboratory/organization performing the testing: 09/25/2018
The quantity of what the sample constitutes: 1 heat 1 powder
A brief description of the sample: #8 green epoxy coated rebar
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC Brighten

Material Information

Rebar Heat Number(s): 4079294
Rebar Epoxy Batch Number(s): UF04735NA
Rebar Coating Specification: ASTM A775
Rebar Size (#): #8
Rebar Coating Color: Green
Rebar Manufacturer: CMC AZ
Rebar Coater: CMC Brighton
Rebar Powder Manufacturer: Akzo Nobel
Release Number: N/A
Quality Assurance Code: N/A
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2018-09-20-3-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 09/26/2018
Date Tested: 09/26/2018
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:
First Bar Mean 12.37
Second Bar Mean 12.15
Lower spec. limit LSL 7
Upper spec. limit USL 16
Bar # for First Bar 1
Bar # for Second Bar 2
Total mean value 12.26
Total number of values less than LSL no data
Total number of values greater than USL no data

Test 2 of 2

DIME Test ID: 2018-09-20-3-2
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 09/26/2018
Date Tested: 09/26/2018
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