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Sample Record for 2019-05-09-3

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

Project Information

Project ID: 213480 DEA: 010J1604 EFIS: 0118000177 QA Service Level: 1
DIST-CO-RTE-PM: 01-MEN,MEN-101-37.4/40.0
Work Description: Storm Damage Repairs - Roadway Stabilization
Location Description:
Contractor Name: Ghilloti Construction Co.
Contractor Address: 246 Ghilloti Ave, Santa Rosa CA 95407
Resident Engineer: Nash Munes Structure Rep.: Dave Wu

Sample Information

DIME Sample ID: 2019-05-09-3
TL Number from the TL Form: C024301
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (530) 329-6527
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 05/09/2019
Date that the sample was received by the laboratory/organization performing the testing: 05/10/2019
The quantity of what the sample constitutes: 4
A brief description of the sample: Couplers
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vinton HRC

Material Information

Production or Authorization Testing: Authorization Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Vinton
Coupler Manufacturer: HRC
Intermediate Assembler or Fabricator: Unknown
Rebar Size: 5
Coupler Model: 500/510
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter: Unknown
Rebar Hoop Fabricator: Unknown
Coupler Component Heat/Lot Number(s): NC787131 75068463
Rebar Heat Number(s): 1910699
Rebar Size 2 :
Coupler Unique ID:

Test Results

Test 1 of 3

DIME Test ID: 2019-05-09-3-1
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 05/10/2019
Date Tested: 05/10/2019
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: Service Splice
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleMfg. Lot Number(s)SizeArea (sqin)Slip (inch)Peak Load (lbf)Peak Stress (psi)CommentsTested By
21#5/16mm0.3102997996706Service SpliceBrian
Temperature 72 F
UTM 400KIP
Halo ID Small

Test 2 of 3

DIME Test ID: 2019-05-09-3-2
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 05/10/2019
Date Tested: 05/10/2019
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: Service Splice
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleMfg. Lot Number(s)SizeArea (sqin)Slip (inch)Peak Load (lbf)Peak Stress (psi)CommentsTested By
21#5/16mm0.3102993496561Service SpliceBrian
Temperature 72 F
UTM 400KIP
Halo ID Small

Test 3 of 3

DIME Test ID: 2019-05-09-3-3
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 05/10/2019
Date Tested: 05/10/2019
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: Service Splice
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleMfg. Lot Number(s)SizeArea (sqin)Slip (inch)Peak Load (lbf)Peak Stress (psi)CommentsTested By
11#5/16mm0.310.00222850491948Service SpliceBrian
Temperature 72 F
UTM 400KIP
Halo ID Small