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Sample Record for 2021-02-03-4

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

Project Information

Project ID: 213653 DEA: 044G8204 EFIS: 0413000049 QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN-101-10.6/10.8
Work Description: REPLACE SAN RAFAEL HARBOR BRIDGE (ABC)
Location Description: MARIN COUTY, IN SAN RAFAEL, FROM ROUTE 101 NORTHBOUND OFF-RAMP TO 2ND STREET
Contractor Name: Gordon N. Ball
Contractor Address: 333 Camille Ave., Alamo, CA 94507
Resident Engineer: Dawit Habteselassie Structure Rep.: Ly, Long N

Sample Information

DIME Sample ID: 2021-02-03-4
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Los Angeles Field Laboratory
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 02/03/2021
Date that the sample was received by the laboratory/organization performing the testing: 02/04/2021
The quantity of what the sample constitutes: 4 Headed Bars from lot 1
A brief description of the sample: #6 button headed bar
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Camblin Steel Service

Material Information

Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 6019603
Head Manufacturer Lot Number(s): 13G2
Rebar Size: #6
Headed Bar Model Name: BNX Buttonhead
Size of Head: Full Size - 9x
Head Connection Type: Forged
Head Shape: Circular
Rebar Manufacturer: CMC Steel California
Head Manufacturer: Bar Splice Products
Head Fabricator: Bar Splice
Material Standard Code: ASTM A706

Test Results

Test 1 of 3

DIME Test ID: 2021-02-03-4-1
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 02/04/2021
Date Tested: 02/04/2021
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: paul.lukkarila@dot.ca.gov
Organization Phone: (916) 227-7253
General Comments for this Test: OK Necking
Additional Comments When Verified:
Number of Headed Bar Samples 1
Lot #Area (sqin)Peak Load (lbf)Tensile Strength (psi)CommentsTested By
10.4447263107416OK Neckingfsaylor
Temperature 72 f
UTM 400kip

Test 2 of 3

DIME Test ID: 2021-02-03-4-2
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 02/04/2021
Date Tested: 02/04/2021
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: paul.lukkarila@dot.ca.gov
Organization Phone: (916) 227-7253
General Comments for this Test: OK Necking
Additional Comments When Verified:
Number of Headed Bar Samples 1
Lot #Area (sqin)Peak Load (lbf)Tensile Strength (psi)CommentsTested By
10.4447426107786OK Neckingfsaylor
Temperature 72 f
UTM 400kip

Test 3 of 3

DIME Test ID: 2021-02-03-4-3
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 02/04/2021
Date Tested: 02/04/2021
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: paul.lukkarila@dot.ca.gov
Organization Phone: (916) 227-7253
General Comments for this Test: OK Necking
Additional Comments When Verified:
Number of Headed Bar Samples 1
Lot #Area (sqin)Peak Load (lbf)Tensile Strength (psi)CommentsTested By
10.4447357107631OK Neckingfsaylor
Temperature 72 f
UTM 400kip

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.