Project Information

Project ID: 994588 DEA: 081H3904 EFIS: 0817000032 QA Service Level: 1

DIST-CO-RTE-PM: 08-SBD-15-R20.5/R21.6,R25.5/R30.7

Work Description: CONSTRUCT BUILDING, ROADWAY EXC, JPCP, AND TEMPORARY BARRIER SYSTEM.

Location Description: SAN BERNARDINO COUNTY FROM 0.6 MILE NORTH OF CLEGHORN ROAD UNDERCROSSING TO 0.5 MILE SOUTH OF ROUTE 138 AND FROM 0.5 MILE SOUTH OF TRUCK SAFETY CHECK AREA TO 0.4 MILE NORTH OF OAK HILL ROAD OVERCROSSING

Contractor Name: POWELL CONSTRUCTORS INC

Contractor Address: 8555 BANANA AVE, FONTANA, CA 92335

Resident Engineer: Mauricio Santa Cruz Structure Rep.: Oluwatayo Ogeyemi

Sample Information

DIME Sample ID: 2024-04-02-5

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 TM7 - Epoxy Coated Rebar

Sample Taken Date: 04/02/2024

Date that the sample was received by the laboratory/organization performing the testing: 04/03/2024

The quantity of what the sample constitutes: 2226 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): 3800042710

Rebar Epoxy Batch Number(s): CH1942KV, CH0943FR

Rebar Coating Specification: ASTM A934

Rebar Size (#): #6

Rebar Coating Color: Purple

Rebar Manufacturer: Nucor

Rebar Coater: American Highway Simplex

Rebar Powder Manufacturer: Sherwin Williams

Release Number:

Quality Assurance Code:

Test Results

Test 1 of 2

DIME Test ID: 2024-04-02-5-1

Test Method: ASTM A934-19: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Epoxy-Coating)

Verified Date: 04/17/2024

Date Tested: 04/16/2024

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: complies

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	8.97
Second Bar Mean	7.72
Total mean value	8.34

Test 2 of 2

DIME Test ID: 2024-04-02-5-2

Test Method: ASTM A934-19: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Holiday Bend)