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Sample Record for 2019-10-28-2

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

Project Information

Project ID: 212036 DEA: 044K2404 EFIS: 0417000284 QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN,MRN-1-10.9, 10.8/10.9, 10.90, 6.6/10.9
Work Description: Construct Solier Pile Wall
Location Description:
Contractor Name: Drill Tech
Contractor Address: 2200 WYMORE WAY, ANTIOCH, CA 94509
Resident Engineer: Dawit Habteselassie Structure Rep.: Jeff Kress

Sample Information

DIME Sample ID: 2019-10-28-2
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 TM5 - Threaded Bar
Sample Taken Date: 10/28/2019
Date that the sample was received by the laboratory/organization performing the testing: 10/31/2019
The quantity of what the sample constitutes: 2
A brief description of the sample: B7X Geo-Drill Injection Bar 32 mm GA
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: William Form Engineering

Material Information

Production or Authorization Testing: Authorization Testing
Threaded Bar Specification: ASTM A513
Threaded Bar Grade: 90
Threaded Bar Type:
Rebar Size:
Nut Specification for Threaded Bar: ASTM A108
System Manufacturer: Williams Form Engineering
Epoxy Coating Color: NA
Threaded Bar Application: Soil Nail
Coating Standards: ASTM A153 galvanized
Bar Heat Number(s): 4173505
Nut Heat Number(s): 8295752
Bar Lot Number: C21032757
Nut Lot Number: Unknown
Coupler Heat Number(s): M54421
Coupler Grade: 12

Test Results

Test 1 of 1

DIME Test ID: 2019-10-28-2-1
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 11/06/2019
Date Tested: 11/01/2019
Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email:
Organization Phone: (562) 500-5861
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 2
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)CommentsTested By
110/32 mm 41735050.556106750992680A513 Bar Nut Heat 3238D Note Nut Strippedbewing
210/32 mm 41735050.556107778969120A513 Bar Nut Heat 3238D Note Nut Strippedbewing
Temperature 72 f