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Sample Record for 2023-08-21-4

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Project Information

Project ID: 212498 DEA: 021H5204 EFIS: 0217000009 QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-3,263-48.5/49.7 - 49.41
Work Description: Roadway Rehabilitation
Location Description: 02-Sis-3, 263-R46.8/R48.0, 49.07/49.41
Contractor Name: Myers-Shea JV
Contractor Address: 45 Morrison Ave, Sacramento, CA 95838
Resident Engineer: Austin Henry Structure Rep.: Nicolas Jimenez

Sample Information

DIME Sample ID: 2023-08-21-4
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: 08/21/2023
Date that the sample was received by the laboratory/organization performing the testing: 08/22/2023
The quantity of what the sample constitutes: 6138 LF
A brief description of the sample: #6 x 30" baskets
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: American Highway - Simplex

Material Information

Rebar Heat Number(s): 4125209
Rebar Epoxy Batch Number(s): CH1932JJ, CH2172HC
Rebar Coating Specification: ASTM A934
Rebar Size (#): #6
Rebar Coating Color: Purple
Rebar Manufacturer: CMC Steel Arizona
Rebar Coater: American Highway Simplex
Rebar Powder Manufacturer: Sherwin Williams
Release Number:
Quality Assurance Code:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2023-08-21-4-1
Test Method: ASTM A934-19: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Epoxy-Coating)
Verified Date: 08/28/2023
Date Tested: 08/23/2023
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:
Test Result Compliance:
Additional Comments When Verified:
Lower spec. limit LSL 7 mils
Upper spec. limit USL 12 mils
Bar # for First Bar 6
Bar # for Second Bar 6
First Bar Mean 11.17
Second Bar Mean 10.11
Total mean value 10.64

Test 2 of 2

DIME Test ID: 2023-08-21-4-2
Test Method: ASTM A934-19: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Holiday Bend)
Verified Date: 08/28/2023
Date Tested: 08/23/2023
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:
Test Result Compliance:
Additional Comments When Verified:
Total Number of Holiday 16
Total Length 5
Holidays Per Linear Foot of Bar 3.2
Holiday Test Pass/Fail Fail
Bend Test Pass/Fail NA