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Sample Record for 2023-07-31-5

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Project Information

Project ID: 214998 DEA: 044H0504 EFIS: 0413000080 QA Service Level: 1
DIST-CO-RTE-PM: 04-SON-12-25.8-33.3
Work Description: BRIDGE SCOUR MITIGATION
Location Description: SONOMA COUNTY NEAR SANTA ROSA AT SONOMA CREEK BRIDGE AND AT HOOKER CREEK BRIDGE
Contractor Name: Ghilotti Construction Co. (Nishit Prajapati)
Contractor Address: 246 Ghilloti Ave, Santa Rosa CA 95407
Resident Engineer: leonard brajnikoff Structure Rep.: Anthony tierra

Sample Information

DIME Sample ID: 2023-07-31-5
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 - Threaded Bar
Sample Taken Date: 07/31/2023
Date that the sample was received by the laboratory/organization performing the testing: 08/03/2023
The quantity of what the sample constitutes: 2 sets
A brief description of the sample: A722 Threaded Bar
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: William Form Engineering

Material Information

Production or Authorization Testing: Production Testing
Threaded Bar Specification: ASTM A722
Threaded Bar Grade: 150
Threaded Bar Type: Plain
Rebar Size:
Nut Specification for Threaded Bar: ASTM A29/A108
System Manufacturer: William Form
Epoxy Coating Color: NA
Threaded Bar Application: Threaded Bar
Coating Standards: Uncoated
Bar Heat Number(s): 58052332
Nut Heat Number(s): 75084199
Bar Lot Number: 5WF06M
Nut Lot Number: 36E9D
Coupler Heat Number(s):
Coupler Grade:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2023-07-31-5-1
Test Method: ASTM A722-18: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
Verified Date: 08/21/2023
Date Tested: 08/17/2023
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: A722 Bar and Nut Reduction of Area
Test Result Compliance:
Additional Comments When Verified:
Number of Threaded Bar Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)Reduction of area (%)CommentsTested By
1ASTM A722 Type II Deformed Bar 1 3/8 : 36mm11.507162330.14138.53022.3A722 Bar and Nut Reduction of Areaspaine
Temperature 72 f
UTM 400kip

Test 2 of 2

DIME Test ID: 2023-07-31-5-2
Test Method: ASTM A722-18: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
Verified Date: 08/21/2023
Date Tested: 08/17/2023
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: A722 Bar and Nut Elongation
Test Result Compliance:
Additional Comments When Verified:
Number of Threaded Bar Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)Reduction of area (%)CommentsTested By
2ASTM A722 Type II Deformed Bar 1 3/8 : 36mm11.58171560.40135.267.27100A722 Bar and Nut Elongationspaine
Temperature 72 f
UTM 400kip