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Sample Record for 2016-12-15-11

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

Project Information

Project ID: 211070 DEA: 080Q3004 EFIS: 0800020191 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-138-R17.1/R19.2
Work Description: REALIGN SECTION OF STATE ROUTE 138
Location Description: Near Hesperia from 1.9 mi East of Route 15 to 0.1 mi West of Summit Post Office Road to realign sections of State Route 138
Contractor Name: Skanska Civil USA
Contractor Address: 1995 Agua Mansa Road, Riverside, CA 92509
Resident Engineer: Amgad Benjamin Structure Rep.: Tim Flores

Sample Information

DIME Sample ID: 2016-12-15-11
TL Number from the TL Form: C750001
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: 12/15/2016
Date that the sample was received by the laboratory/organization performing the testing: 01/03/2017
The quantity of what the sample constitutes: 4
A brief description of the sample: HRC 500 510 Couplers
From where was the sample collected: Job Site
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: HRC Gerdau

Material Information

Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Gerdau
Coupler Manufacturer: HRC
Intermediate Assembler or Fabricator: Unknown
Rebar Size: #14
Coupler Model: 500 510
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter: Unknown
Rebar Hoop Fabricator: Unknown
Coupler Component Heat/Lot Number(s): 58018522, 73091916, 74095974
Rebar Heat Number(s): 6502198302
Rebar Size 2 :
Coupler Unique ID:

Test Results

Test 1 of 3

DIME Test ID: 2016-12-15-11-1
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 01/05/2017
Date Tested: 01/04/2017
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: necking okay
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
11#14/43mm2.25-0.009521288394615necking okayFred
Temperature 72 F
UTM 2000KIP
Halo ID Big

Test 2 of 3

DIME Test ID: 2016-12-15-11-2
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 01/05/2017
Date Tested: 01/04/2017
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: necking okay
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
21#14/43mm2.25021199894221necking okayFred
Temperature 72 F
UTM 2000KIP
Halo ID Big

Test 3 of 3

DIME Test ID: 2016-12-15-11-3
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 01/05/2017
Date Tested: 01/04/2017
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: necking okay
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
31#14/43mm2.25021228394348necking okayFred
Temperature 72 F
UTM 2000KIP
Halo ID Big