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Sample Record for 2022-05-04-6

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

Project Information

Project ID: 213707 DEA: 081C38U4 EFIS: 0817000196 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-10-6.7/R25.1
Work Description: Remove concrete pavement and base, and place HMA and JPCP
Location Description: ROUTE 10/60 SEPARATION IN BEAUMONT TO ROUTE 10/111 SEPARATION NEAR CABAZON.
Contractor Name: Coffman Specialties
Contractor Address: 9685 Via Excelencia, San Diego, CA 92126
Resident Engineer: Elvira Lenart Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2022-05-04-6
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 TM7 - Epoxy Coated Rebar
Sample Taken Date: 05/04/2022
Date that the sample was received by the laboratory/organization performing the testing: 05/09/2022
The quantity of what the sample constitutes: 2
A brief description of the sample: ASTM A706 Grade 60 epoxy coated bar
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Fletcher Coating Co

Material Information

Rebar Heat Number(s): 1202040468
Rebar Epoxy Batch Number(s): 1M13
Rebar Coating Specification: ASTM A934
Rebar Size (#): 6
Rebar Coating Color: Purple
Rebar Manufacturer: Nucor
Rebar Coater: Fletcher Coating Company
Rebar Powder Manufacturer: 3M
Release Number: 32755
Quality Assurance Code: A93422E04R2S11M13
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2022-05-04-6-1
Test Method: ASTM A934-19: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Epoxy-Coating)
Verified Date: 05/17/2022
Date Tested: 05/17/2022
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:
Lower spec. limit LSL 7 mils
Upper spec. limit USL 12 mils
Bar # for First Bar 1
Bar # for Second Bar 2
First Bar Mean 9.05
Second Bar Mean 9.61
Total mean value 9.33

Test 2 of 2

DIME Test ID: 2022-05-04-6-2
Test Method: ASTM A934-13: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Holiday Bend)
Verified Date: 05/17/2022
Date Tested: 05/17/2022
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 0
Total Length 5
Holidays Per Linear Foot of Bar 0
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass