Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 213569 DEA: 024F2104 EFIS: 0212000072
QA Service Level: 1
DIST-CO-RTE-PM: 02-MOD-299-0.5/1.0
Work Description: Butte and Ash Creek Bridge Replacement
Location Description: Construction of Butte Creek Bridge and Ash Creek Bridge on Route 299 at Adin
Contractor Name: WEST COAST CONTRACTORS
Contractor Address: 61050 Highway 101, Coos Bay, Oregon 97420
Resident Engineer: Mike Zdenek Structure Rep.: Ryan G Duran
DIME Sample ID: 2019-04-30-1
TL Number from the TL Form:
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: 04/30/2019
Date that the sample was received by the laboratory/organization performing the testing: 04/30/2019
The quantity of what the sample constitutes: 3
A brief description of the sample: Epoxy Coated Rebar
From where was the sample collected: Fabricator
Laboratory sample identification: C190753
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC Rebar Colorado
Rebar Heat Number(s): 4085519
Rebar Epoxy Batch Number(s): VB17543NA
Rebar Coating Specification: ASTM A775
Rebar Size (#): 4
Rebar Coating Color: Green
Rebar Manufacturer: CMC Rebar
Rebar Coater: AkzoNobel
Rebar Powder Manufacturer: AKZOnOBEL
Release Number: Unknown
Quality Assurance Code: Unknown
DIME Test ID: 2019-04-30-1-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 05/09/2019
Date Tested: 05/08/2019
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
|
11.3
|
Second Bar Mean
|
11.25
|
Lower spec. limit LSL
|
7
|
Upper spec. limit USL
|
12
|
Bar # for First Bar
|
1
|
Bar # for Second Bar
|
2
|
Total mean value
|
11.28
|
Total number of values less than LSL
|
no data
|
Total number of values greater than USL
|
no data
|
DIME Test ID: 2019-04-30-1-2
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 05/09/2019
Date Tested: 05/08/2019
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
|
0
|
Total Length
|
5
|
Holidays Per Linear Foot of Bar
|
0
|
Holiday Test Pass/Fail
|
Pass
|
Bend Test Pass/Fail
|
Pass
|