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Sample Record for 2021-04-06-1

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

Project Information

Project ID: 215063 DEA: 032F5704 EFIS: 0300020615 QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-80-46.3/63.5
Work Description: Replace 4 Bridges (OC) on Highway 80 from Crystal Springs to Cisco Grove (Baxter, Drum Forebay)
Location Description:
Contractor Name: Walsh Construction Company II, LLC (Walsh)
Contractor Address: 1390 Willow Pass Road Suite 950, Concord, CA 94520
Resident Engineer: Tad Sampson Structure Rep.: Jimmer Ross

Sample Information

DIME Sample ID: 2021-04-06-1
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7263
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 04/06/2021
Date that the sample was received by the laboratory/organization performing the testing: 04/07/2021
The quantity of what the sample constitutes: 4
A brief description of the sample: #9 Button Head Galvanized
From where was the sample collected: Other
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Galvanizing

Material Information

Production or Authorization Testing: Retest
Rebar Heat Number(s): 4101383
Head Manufacturer Lot Number(s): A204230 A202389
Rebar Size: #9
Headed Bar Model Name: GripTwist and Grip Twist Doughnut 10Ab
Size of Head: Full Size - 9x
Head Connection Type: Friction Weld
Head Shape: Circular
Rebar Manufacturer: CMC
Head Manufacturer: Barsplice
Head Fabricator: Camblin Steel
Material Standard Code: ASTM A706

Test Results

Test 1 of 4

DIME Test ID: 2021-04-06-1-1
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical)
Verified Date: 04/08/2021
Date Tested: 04/08/2021
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: End Anchor; OK Necking
Test Result Compliance:
Additional Comments When Verified:
Number of Samples Tested 1
SampleNumber of CyclesSizeMfg. Lot Number(s)Area (sqin)Peak Load (lbf)Peak Stress (psi)CommentsTested By
1No. 9/29mm119179891798End Anchorfsaylor
UTM 400kip
Temperature 72.00 f

Test 2 of 4

DIME Test ID: 2021-04-06-1-2
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical)
Verified Date: 04/08/2021
Date Tested: 04/08/2021
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: End Anchor; OK Necking
Test Result Compliance:
Additional Comments When Verified:
Number of Samples Tested 1
SampleNumber of CyclesSizeMfg. Lot Number(s)Area (sqin)Peak Load (lbf)Peak Stress (psi)CommentsTested By
2No. 9/29mm119171791717End Anchorfsaylor
UTM 400kip
Temperature 72.00 f

Test 3 of 4

DIME Test ID: 2021-04-06-1-3
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical)
Verified Date: 04/08/2021
Date Tested: 04/08/2021
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: End Anchor; OK Necking
Test Result Compliance:
Additional Comments When Verified:
Number of Samples Tested 1
SampleNumber of CyclesSizeMfg. Lot Number(s)Area (sqin)Peak Load (lbf)Peak Stress (psi)CommentsTested By
3No. 9/29mm119169591695End Anchorfsaylor
UTM 400kip
Temperature 72.00 f

Test 4 of 4

DIME Test ID: 2021-04-06-1-4
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical)
Verified Date: 04/08/2021
Date Tested: 04/08/2021
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: End Anchor; OK Necking
Test Result Compliance:
Additional Comments When Verified:
Number of Samples Tested 1
SampleNumber of CyclesSizeMfg. Lot Number(s)Area (sqin)Peak Load (lbf)Peak Stress (psi)CommentsTested By
4No. 9/29mm119183991839End Anchorfsaylor
UTM 400kip
Temperature 72.00 f

Tests Assigned to this Sample

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