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Sample Record for 2019-04-16-11

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

Project Information

Project ID: 210862 DEA: 031F4004 EFIS: 0300020420 QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-80-35.1/38.3
Work Description: WIDEN EASTBOUND ROADWAY
Location Description: WIDEN EASTBOUND ROADWAY
Contractor Name: A. TEICHERT & SON, INC. DBA TEICHERT CONSTRUCTION
Contractor Address: 400 Sunrise Ave. Ste. 300, Roseville, CA 95661
Resident Engineer: Phil Zink Structure Rep.: Carl Anderson

Sample Information

DIME Sample ID: 2019-04-16-11
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Quality Assurance
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 04/16/2019
Date that the sample was received by the laboratory/organization performing the testing: 04/19/2019
The quantity of what the sample constitutes: 40128
A brief description of the sample: #6 A775 Epoxy Coated rebar
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC Rebar Brighton

Material Information

Rebar Heat Number(s): 4078504, 4078632
Rebar Epoxy Batch Number(s): VA04353NA
Rebar Coating Specification: ASTM A775
Rebar Size (#): 6
Rebar Coating Color: Green
Rebar Manufacturer: CMC
Rebar Coater: CMC Rebar Brighton
Rebar Powder Manufacturer: Akzo Nobel
Release Number: 421172
Quality Assurance Code:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2019-04-16-11-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 04/23/2019
Date Tested: 04/22/2019
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 10.62
Second Bar Mean 9.99
Lower spec. limit LSL 7
Upper spec. limit USL 16
Bar # for First Bar 1
Bar # for Second Bar 2
Total mean value 10.3
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: 2019-04-16-11-2
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 04/23/2019
Date Tested: 04/22/2019
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 no data0
Total Length 5
Holidays Per Linear Foot of Bar no data0 holiday per ft
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass