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Sample Record for 2021-09-20-2

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

Project Information

Project ID: 77777 DEA: CHEM-STOCK EFIS: CHEM-STOCK QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for Chem Lab stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-09-20-2
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Authorization
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 09/20/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/24/2021
The quantity of what the sample constitutes: Audit
A brief description of the sample: #9 A775 Rebar
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC Brighton CO

Material Information

Rebar Heat Number(s): 6025769
Rebar Epoxy Batch Number(s): XG00879NA
Rebar Coating Specification: ASTM A775
Rebar Size (#): 9
Rebar Coating Color: Green
Rebar Manufacturer: CMC OK
Rebar Coater: CMC Brighton CO
Rebar Powder Manufacturer: AzkoNoble
Release Number: Audit
Quality Assurance Code:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2021-09-20-2-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 09/28/2021
Date Tested: 09/28/2021
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:
Test Result Compliance:
Additional Comments When Verified:
Total Number of Holiday no data0
Total Length 6
Holidays Per Linear Foot of Bar no data0 holiday per ft
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass

Test 2 of 2

DIME Test ID: 2021-09-20-2-2
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 09/28/2021
Date Tested: 09/28/2021
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:
Test Result Compliance:
Additional Comments When Verified:
First Bar Mean 13.16
Second Bar Mean 13.87
Lower spec. limit LSL 7
Upper spec. limit USL 16
Bar # for First Bar 1
Bar # for Second Bar 2
Total mean value 13.51
Total number of values less than LSL no data
Total number of values greater than USL no data