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Sample Record for 2024-03-26-66

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

Project Information

Project ID: 88888 DEA: SMTL-STOCK EFIS: SMTL-STOCK QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for SMTL stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2024-03-26-66
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (530) 329-6527
Type of Sample: Department Acceptance
Type of Material: SMTL TM5 - Threaded Bar
Sample Taken Date: 03/26/2024
Date that the sample was received by the laboratory/organization performing the testing: 04/02/2024
The quantity of what the sample constitutes: 6
A brief description of the sample: 1" A722 Type II Threaded Bar
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Williams Form

Material Information

Production or Authorization Testing: Authorization Testing
Threaded Bar Specification: ASTM A722
Threaded Bar Grade: 150
Threaded Bar Type: Deformed
Rebar Size:
Nut Specification for Threaded Bar: A29
System Manufacturer: Williams Form
Epoxy Coating Color: NA
Threaded Bar Application:
Coating Standards: Uncoated
Bar Heat Number(s): 58053048
Nut Heat Number(s): 5393688
Bar Lot Number:
Nut Lot Number: 26G5D
Coupler Heat Number(s): 201435
Coupler Grade:

Test Results

Test 1 of 5

DIME Test ID: 2024-03-26-66-1
Test Method: ASTM A722-18: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
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
Data has not been verified.

Test 2 of 5

DIME Test ID: 2024-03-26-66-2
Test Method: ASTM A722-18: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
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
Data has not been verified.

Test 3 of 5

DIME Test ID: 2024-03-26-66-3
Test Method: ASTM A722-18: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
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
Data has not been verified.

Test 4 of 5

DIME Test ID: 2024-03-26-66-4
Test Method: ASTM A722-18: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
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
Data has not been verified.

Test 5 of 5

DIME Test ID: 2024-03-26-66-5
Test Method: ASTM A722-18: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
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
Data has not been verified.