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Sample Record for 2021-09-10-1

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Project Information

Project ID: 214579 DEA: 010B0904 EFIS: 0100020444 QA Service Level: 1
DIST-CO-RTE-PM: 01-DN-101-8.2/8.7
Work Description: Panther Creek & Hunter Creek Bridges
Location Description: DEL NORTE COUNTY NEAR KLAMATH AT PANTHER CREEK BRIDGE AND AT HUNTER CREEK BRIDGE
Contractor Name: Golden State Bridge, Inc
Contractor Address: 3701 Mallard Dr., Benicia, CA 94510
Resident Engineer: Ryan Dunne Structure Rep.: Brian Cinkutis

Sample Information

DIME Sample ID: 2021-09-10-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 09/10/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/15/2021
The quantity of what the sample constitutes: (16) #6 1'-5" 150 T-Heads
A brief description of the sample: (4) #6 4'-0" 150 T-Heads
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: HRC

Material Information

Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 4110390
Head Manufacturer Lot Number(s): Lot 1
Rebar Size: #6
Headed Bar Model Name: Type 150
Size of Head: Full Size - 9x
Head Connection Type: Friction Weld
Head Shape: Square
Rebar Manufacturer: CMC
Head Manufacturer: HRC Fountain Valley
Head Fabricator: HRC Fountain Valley
Material Standard Code: ASTM A706
Headed Bar Unique ID:
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2021-09-10-1-1
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 09/15/2021
Date Tested: 09/15/2021
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: OK Necking
Test Result Compliance:
Additional Comments When Verified:
Number of Headed Bar Samples 1
Lot #Area (sqin)Peak Load (lbf)Tensile Strength (psi)CommentsTested By
10.444243196435OK Neckingfsaylor
Temperature 72 f
UTM 400kip

Test 2 of 3

DIME Test ID: 2021-09-10-1-2
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 09/15/2021
Date Tested: 09/15/2021
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: OK Necking
Test Result Compliance:
Additional Comments When Verified:
Number of Headed Bar Samples 1
Lot #Area (sqin)Peak Load (lbf)Tensile Strength (psi)CommentsTested By
10.444239196344OK Neckingfsaylor
Temperature 72 f
UTM 400kip

Test 3 of 3

DIME Test ID: 2021-09-10-1-3
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 09/15/2021
Date Tested: 09/15/2021
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: OK Necking
Test Result Compliance:
Additional Comments When Verified:
Number of Headed Bar Samples 1
Lot #Area (sqin)Peak Load (lbf)Tensile Strength (psi)CommentsTested By
10.444235496259OK Neckingfsaylor
Temperature 72 f
UTM 400kip