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Sample Record for 2023-02-07-1

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Project Information

Project ID: 214355 DEA: 120K0214 EFIS: 1214000096 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-5-12.4/14.5
Work Description: South County Improvement Project (Phase 1 - Avery/Crown Valley) PLACE HMA, INSTALL CONC PAVEMENT, RETAIN WALL, MODIFY ELECT SYS. | Add one lane btwn 73 & Oso PKWY
Location Description: ORANGE COUNTY IN SAN JUAN CAPISTRANO, LAGUNA HILLS, LAGUNA NIGUEL AND MISSION VIEJO FROM 0.5 MILE SOUTH OF AVERY PARKWAY UNDERCROSSING TO 0.8 MILE NORTH OF CROWN VALLEY PARKWAY OVERCROSSING
Contractor Name: ORTIZ ENTERPRISES, INC.
Contractor Address: 6 Cushing, Suite 200, Irvine, CA 92618
Resident Engineer: Kifah Ramadan Structure Rep.: Imad Karam

Sample Information

DIME Sample ID: 2023-02-07-1
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: 02/07/2023
Date that the sample was received by the laboratory/organization performing the testing: 02/09/2023
The quantity of what the sample constitutes: 10
A brief description of the sample: #9 headed bar with grip-twist doughnut 10Ab
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Integrity Rebar

Material Information

Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 388922
Head Manufacturer Lot Number(s): 7Y1, 1W1
Rebar Size: #9
Headed Bar Model Name: 10A Taper Threaded DoughNUT Termination Syste
Size of Head: Full Size - 9x
Head Connection Type: Taper Threaded
Head Shape: Circular
Rebar Manufacturer: Cascade Steel
Head Manufacturer: Barsplice
Head Fabricator: Barsplice
Material Standard Code: ASTM A706
Headed Bar Unique ID: 9TT-17-01

Test Results

Test 1 of 3

DIME Test ID: 2023-02-07-1-1
Test Method: ASTM A970-18: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 02/14/2023
Date Tested: 02/10/2023
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
11100912100912Ok Neckingspaine
Temperature 72 f
UTM 400kip

Test 2 of 3

DIME Test ID: 2023-02-07-1-2
Test Method: ASTM A970-18: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 02/14/2023
Date Tested: 02/10/2023
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
119937699376Ok Neckingspaine
Temperature 72 f
UTM 400kip

Test 3 of 3

DIME Test ID: 2023-02-07-1-3
Test Method: ASTM A970-18: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 02/14/2023
Date Tested: 02/10/2023
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
119715297152Ok Neckingspaine
Temperature 72 f
UTM 400kip