Project Information

Project ID: 214190 DEA: 024G41U4 EFIS: 0218000047 QA Service Level: 1

DIST-CO-RTE-PM: 02-SIS,SIS-5-Var

Work Description: REPLACE REINFORCED CONCRETE BRIDGES & CONSTRUCT RETAINING WALL.

Location Description: SHASTA AND SISKIYOU COUNTIES ABOUT 7 MILES NORTH OF POLLARD FLAT FROM 0.8 MILE SOUTH TO 0.7 MILE NORTH OF SIMS ROAD UNDERCROSSING AND FROM 0.6 MILE SOUTH OF CASTLE CRAGS DRIVE UNDERCROSSING TO 0.2 MILE SOUTH OF SOUTH DUNSMUIR UNDERCROSSING

Contractor Name: J.F. Shea Construction, Inc.

Contractor Address: 17400 Clear Creek Road, Redding, CA 96001

Resident Engineer: Nicole Mallory Structure Rep.: Adam Scardaci

Sample Information

DIME Sample ID: 2020-05-01-2

TL Number from the TL Form:

Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office

Sample Organization Contact: (916) 227-7263

Type of Sample: Acceptance

Type of Material: SMTL TM7 - Epoxy Coated Rebar

Sample Taken Date: 05/01/2020

Date that the sample was received by the laboratory/organization performing the testing: 05/05/2020

The quantity of what the sample constitutes: 12,803 lbs

A brief description of the sample: #5 ASTM A775 Epoxy Coated Rebar

From where was the sample collected: Job Site

Laboratory sample identification:

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: Western Coatings

Material Information

Rebar Heat Number(s): 445119

Rebar Epoxy Batch Number(s): 3CH1936008

Rebar Coating Specification: ASTM A775

Rebar Size (#): 5

Rebar Coating Color: Green

Rebar Manufacturer: Cascade

Rebar Coater: Western Coating Eugene OR

Rebar Powder Manufacturer: Valspar

Release Number: 45854

Quality Assurance Code: Unknown

Test Results

Test 1 of 2

DIME Test ID: 2020-05-01-2-1

Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)

Verified Date: 05/11/2020

Date Tested: 05/07/2020

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: paul.lukkarila@dot.ca.gov

Organization Phone: 916-227-7257

General Comments for this Test:

Test Result Compliance:

Additional Comments When Verified:

First Bar Mean	8.18
Second Bar Mean	8.29
Lower spec. limit LSL	7
Upper spec. limit USL	12
Bar # for First Bar	1
Bar # for Second Bar	2
Total mean value	8.23
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: 2020-05-01-2-3

Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)