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Sample Record for 2016-09-08-1

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

Project Information

Project ID: 208714 DEA: 08043514 EFIS: 0800000010 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-58-R22.2/R31.1
Work Description: REALIGN AND WIDEN 2 TO 4 LANES EXPRESSWAY
Location Description: HINKLEY ROAD FROM 2.4 MILES WEST OF HIDDEN RIVER ROAD TO? 0.7 MILE EAST OF LENWOOD ROAD.
Contractor Name: Skanska Civil USA
Contractor Address: 1995 Agua Mansa Road, Riverside, CA 92509
Resident Engineer: Shaine Shahidi Structure Rep.: Ahmad Ankir

Sample Information

DIME Sample ID: 2016-09-08-1
TL Number from the TL Form: C970779
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 TM7 - Epoxy Coated Rebar
Sample Taken Date: 09/08/2016
Date that the sample was received by the laboratory/organization performing the testing: 09/12/2016
The quantity of what the sample constitutes: 2
A brief description of the sample: Epoxy Coated Dowel
From where was the sample collected: Source
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: JC Supply Manufacturing

Material Information

Rebar Heat Number(s): PL16104266
Rebar Epoxy Batch Number(s): 6F10B36A
Rebar Coating Specification: ASTM A775
Rebar Size (#): 1.5
Rebar Coating Color: Green
Rebar Manufacturer: Nucor
Rebar Coater: JC Supply And Manufacturing
Rebar Powder Manufacturer: 3M
Release Number: Unknown
Quality Assurance Code: Unknown
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2016-09-08-1-6
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 09/13/2016
Date Tested: 09/13/2016
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: A775 A884
Test Result Compliance: complies
Additional Comments When Verified:
Total Number of Holiday 0
Total Length 3 ft
Holidays Per Linear Foot of Bar 0 holiday pe
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail NA

Test 2 of 2

DIME Test ID: 2016-09-08-1-7
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 09/13/2016
Date Tested: 09/12/2016
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: A775 A884
Test Result Compliance: complies
Additional Comments When Verified:
First Bar Mean 11.39
Second Bar Mean 11.72
Lower spec. limit LSL 7 mils
Upper spec. limit USL 40 mils
Bar # for First Bar no data
Bar # for Second Bar no data
Total mean value 11.55 mils
Total number of values less than LSL no data
Total number of values greater than USL no data