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Sample Record for 2016-08-29-1

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

Project Information

Project ID: 210862 DEA: 031F4004 EFIS: 0300020420 QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-80-35.1/38.3
Work Description: WIDEN EASTBOUND ROADWAY
Location Description: WIDEN EASTBOUND ROADWAY
Contractor Name: A. TEICHERT & SON, INC. DBA TEICHERT CONSTRUCTION
Contractor Address: 400 Sunrise Ave. Ste. 300, Roseville, CA 95661
Resident Engineer: Phil Zink Structure Rep.: Carl Anderson

Sample Information

DIME Sample ID: 2016-08-29-1
TL Number from the TL Form: C874905
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (530) 329-6527
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 08/29/2016
Date that the sample was received by the laboratory/organization performing the testing: 08/29/2016
The quantity of what the sample constitutes: 4
A brief description of the sample: Lenton Couplers
From where was the sample collected: Job Site
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC Erico

Material Information

Production or Authorization Testing: Production Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: CMC
Coupler Manufacturer: Erico
Intermediate Assembler or Fabricator: Unknown
Rebar Size: 4
Coupler Model: Lenton Formsaver
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter: Unknown
Rebar Hoop Fabricator: Unknown
Coupler Component Heat/Lot Number(s): L8802
Rebar Heat Number(s): 4056574
Rebar Size 2 :
Coupler Unique ID:

Test Results

Test 1 of 3

DIME Test ID: 2016-08-29-1-1
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 08/31/2016
Date Tested: 08/30/2016
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: Service Splice
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleMfg. Lot Number(s)SizeArea (sqin)Slip (inch)Peak Load (lbf)Peak Stress (psi)CommentsTested By
1#4/13mm0.20.00311740587025Service SpliceBrian
Temperature 72 F
UTM 400KIP
Halo ID Small

Test 2 of 3

DIME Test ID: 2016-08-29-1-2
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 08/31/2016
Date Tested: 08/30/2016
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: Service Splice
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleMfg. Lot Number(s)SizeArea (sqin)Slip (inch)Peak Load (lbf)Peak Stress (psi)CommentsTested By
2#4/13mm0.201800290010Service SpliceBrian
Temperature 72 F
UTM 400KIP
Halo ID Small

Test 3 of 3

DIME Test ID: 2016-08-29-1-3
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 08/31/2016
Date Tested: 08/30/2016
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: Service Splice
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleMfg. Lot Number(s)SizeArea (sqin)Slip (inch)Peak Load (lbf)Peak Stress (psi)CommentsTested By
3#4/13mm0.201617280860Service SpliceBrian
Temperature 72 F
UTM 400KIP
Halo ID Small