Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214836 DEA: 030G9804 EFIS: 0317000313
QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-80-46.3/53.4
Work Description: CONCRETE SLAB REPLACEMENT.
Location Description: PLACER COUNTY FR0M CRYSTAL SPRINGS ROAD OVERCROSSING TO BLUE CANYON ROAD UNDERCROSSING
Contractor Name: FBD VANGUARD CONSTRUCTION, INC.
Contractor Address: 550 Greenville Road, Livermore, CA 94550
Resident Engineer: Tad Sampson Structure Rep.: Unknown
DIME Sample ID: 2020-08-06-5
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Acceptance
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 08/06/2020
Date that the sample was received by the laboratory/organization performing the testing: 08/11/2020
The quantity of what the sample constitutes: 3500 lbs
A brief description of the sample: #6 Tiebars purple
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Simplex - Fernley, NV
Rebar Heat Number(s): 1201020033
Rebar Epoxy Batch Number(s): 3CH2010022
Rebar Coating Specification: ASTM A934
Rebar Size (#): 6
Rebar Coating Color: Purple
Rebar Manufacturer: Nucor
Rebar Coater: Simplex
Rebar Powder Manufacturer: Valspar
Release Number: 107393-1
Quality Assurance Code:
DIME Test ID: 2020-08-06-5-1
Test Method: ASTM A934-13: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Epoxy-Coating)
Verified Date: 08/13/2020
Date Tested: 08/12/2020
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: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Lower spec. limit LSL
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7 mils
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Upper spec. limit USL
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12 mils
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Bar # for First Bar
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1
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Bar # for Second Bar
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1
|
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First Bar Mean
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20.58
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Second Bar Mean
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18.82
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Total mean value
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19.7
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