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Sample Record for 2019-04-30-2

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

Project Information

Project ID: 212363 DEA: 07333404 EFIS: 0716000306 QA Service Level: 1
DIST-CO-RTE-PM: 07---
Work Description:
Location Description:
Contractor Name: C. A. RASMUSSEN, INC.
Contractor Address: 28548 LIVINGSTON AVENUE, VALENCIA CA 91355
Resident Engineer: James Riley Structure Rep.: Frank Lotfi

Sample Information

DIME Sample ID: 2019-04-30-2
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

Material Information

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: Resicoat
Release Number: Unknown
Quality Assurance Code: Unknown

Test Results

Test 1 of 2

DIME Test ID: 2019-04-30-2-1
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 10.5
Second Bar Mean 9.97
Lower spec. limit LSL 7
Upper spec. limit USL 12
Bar # for First Bar 1
Bar # for Second Bar 2
Total mean value 10.23
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: 2019-04-30-2-2
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 1
Total Length 5
Holidays Per Linear Foot of Bar 0.2
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass