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Sample Record for 2016-11-01-6

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

Project Information

Project ID: 210569 DEA: 083555V4 EFIS: 0814000086 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-42.5/46.0
Work Description: WIDEN I-15, RECONSTRUCT 3 IC'S, CONSTRUCT 2 NEW BR AND WIDEN 3 BR.
Location Description: SAN BERNARDINO COUNTY IN VICTORVILLE FROM 0.5 MILE NORTH OF MOJAVE DRIVE TO 1.5 MILE NORTH OF STODDARD WELLS ROAD OVERCROSSING
Contractor Name: Ames Construction
Contractor Address: 2000 AMES DRIVE, BURNSVILLE, MN 55306
Resident Engineer: Taghreed Al-Khateeb Structure Rep.: Ravinder Singh

Sample Information

DIME Sample ID: 2016-11-01-6
TL Number from the TL Form: C731319
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 - Threaded Bar
Sample Taken Date: 11/01/2016
Date that the sample was received by the laboratory/organization performing the testing: 11/07/2016
The quantity of what the sample constitutes: 2
A brief description of the sample: Williams Thread Bars
From where was the sample collected: Manufacturer
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Williams Form

Material Information

Production or Authorization Testing: Production Testing
Threaded Bar Specification: ASTM A615
Threaded Bar Grade: 75
Threaded Bar Type: Deformed
Rebar Size: Unknown
Nut Specification for Threaded Bar: NA
System Manufacturer: Williams Form
Epoxy Coating Color: Purple
Threaded Bar Application: Soil Nail
Coating Standards: ASTM A934 epoxy
Bar Heat Number(s): NF16203245
Nut Heat Number(s): Unknown
Bar Lot Number:
Nut Lot Number:
Coupler Heat Number(s):
Coupler Grade:

Test Results

Test 1 of 2

DIME Test ID: 2016-11-01-6-1
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 11/08/2016
Date Tested: 11/08/2016
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: A165 Bar
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)CommentsTested By
1#9 Bar Heat #NF16203245L6715116L53037161124486937948.3A165 BarFred
Temperature 72 F
UTM 400KIP

Test 2 of 2

DIME Test ID: 2016-11-01-6-2
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 11/08/2016
Date Tested: 11/08/2016
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: A615 Bar
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)CommentsTested By
2#9 Bar Heat #NF16203245L6715116L53037161124482928600A615 BarFred
Temperature 72 F
UTM 400KIP