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Sample Record for 2021-07-09-2

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

Project Information

Project ID: 215188 DEA: 080F5434 EFIS: 0817000239 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-I-15,SR-91-6.1-7.6
Work Description: I-15 ELC: 15/91 Express Lanes Connector Project (ELC)
Location Description: Junction of I-15 and SR-91 in Corona, CA
Contractor Name: Myers-Rados Joint Venture
Contractor Address: 629 N. Main Street, Suite C3, Corona, CA 92878
Resident Engineer: Roy Fisher Structure Rep.: Luis Negrete

Sample Information

DIME Sample ID: 2021-07-09-2
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 - Threaded Bar
Sample Taken Date: 07/09/2021
Date that the sample was received by the laboratory/organization performing the testing: 07/16/2021
The quantity of what the sample constitutes: Heat 100108100
A brief description of the sample: A615 Grade 75 Threaded Bar
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name: RW No 5
The fabricator/manufacturer/facility name: Williams Form Engineering Golden, CO

Material Information

Production or Authorization Testing: Production Testing
Threaded Bar Specification: ASTM A615
Threaded Bar Grade: 75
Threaded Bar Type: Deformed
Rebar Size: #9
Nut Specification for Threaded Bar: ASTM A108
System Manufacturer: Williams Form Engineering
Epoxy Coating Color: NA
Threaded Bar Application: Soil Nail
Coating Standards: Uncoated
Bar Heat Number(s): 100108100
Nut Heat Number(s): 8391467
Bar Lot Number: NA
Nut Lot Number: 9L3D
Coupler Heat Number(s): NA
Coupler Grade: NA

Test Results

Test 1 of 3

DIME Test ID: 2021-07-09-2-1
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 07/20/2021
Date Tested: 07/20/2021
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: Nut Stipped off need Grip Pull Bar for true Elongation
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)CommentsTested By
No.9/29mm1112961861983.14Nut Stipped off need Grip Pull Bar for true Elongationfsaylor
Temperature 72 f
UTM 400kip

Test 2 of 3

DIME Test ID: 2021-07-09-2-2
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 07/20/2021
Date Tested: 07/20/2021
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: Grip Pull
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)CommentsTested By
No.9/29mm111877711320011.17Grip Pullfsaylor
Temperature 72 f
UTM 400kip

Test 3 of 3

DIME Test ID: 2021-07-09-2-3
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 07/20/2021
Date Tested: 07/20/2021
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: Grip Pull
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)CommentsTested By
No.9/29mm1117815901540Grip Pullfsaylor
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.