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Sample Record for 2021-08-31-2

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Project Information

Project ID: 213099 DEA: 041A6614 EFIS: 0415000291 COOP: 042683A1 QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN-101-8.4
Work Description: CONSTRUCTION ON STATE HIGHWAY IN MARIN COUNTY IN LARKSPUR
Location Description:
Contractor Name: Disney Construction
Contractor Address: 533 airport Blvd, Suite 120, Burlingame, CA 94010
Resident Engineer: Steven Russell Structure Rep.: Long Ly

Sample Information

DIME Sample ID: 2021-08-31-2
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 - Couplers
Sample Taken Date: 08/31/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/07/2021
The quantity of what the sample constitutes: Lot 4
A brief description of the sample: #5 Lenton Threaded Bar Couplers
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
Service or Ultimate: Service
Material Standard Code: ASTM A615
Material Grade: 60
Rebar Manufacturer: Vinton Steel
Coupler Manufacturer: Erico International
Intermediate Assembler or Fabricator:
Rebar Size: #5
Coupler Model: Lenton Form Saver
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): 202040/9830
Rebar Heat Number(s): 2121471, 2121499, 2121500
Rebar Size 2 :

Test Results

Test 1 of 3

DIME Test ID: 2021-08-31-2-1
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical/Fatique Tensile with Slip)
Verified Date: 09/09/2021
Date Tested: 09/09/2021
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: Service Splice
Test Result Compliance:
Additional Comments When Verified:
Number of Samples Tested 1
SampleNumber of CyclesSizeMfg. Lot Number(s)Slip (inch)Area (sqin)Peak Load (lbf)Peak Stress (psi)CommentsTested By
1No. 5/16mm4-0.00110.3133202107103Service Splicefsaylor
UTM 400kip
Temperature 72.00 f
Halo ID Small

Test 2 of 3

DIME Test ID: 2021-08-31-2-2
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical/Fatique Tensile with Slip)
Verified Date: 09/09/2021
Date Tested: 09/09/2021
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: Service Splice
Test Result Compliance:
Additional Comments When Verified:
Number of Samples Tested 1
SampleNumber of CyclesSizeMfg. Lot Number(s)Slip (inch)Area (sqin)Peak Load (lbf)Peak Stress (psi)CommentsTested By
2No. 5/16mm400.3131418101348Service Splicefsaylor
UTM 400kip
Temperature 72.00 f
Halo ID

Test 3 of 3

DIME Test ID: 2021-08-31-2-3
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical/Fatique Tensile with Slip)
Verified Date: 09/09/2021
Date Tested: 09/09/2021
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: Service Splice
Test Result Compliance:
Additional Comments When Verified:
Number of Samples Tested 1
SampleNumber of CyclesSizeMfg. Lot Number(s)Slip (inch)Area (sqin)Peak Load (lbf)Peak Stress (psi)CommentsTested By
3No. 5/16mm400.3132536104956Service Splicefsaylor
UTM 400kip
Temperature 72.00 f
Halo ID

Tests Assigned to this Sample

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