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Sample Record for 2020-06-30-3

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Project Information

Project ID: 214511 DEA: 010E0004 EFIS: 0113000091 QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-101-84.4/84.8
Work Description: BRIDGE RAIL REPLACEMENT.
Location Description: HUMBOLDT COUNTY NEAR ARCATA FROM JACOBY CREEK BRIDGE TO GANNON SLOUGH BRIDGE
Contractor Name: Golden State Bridge
Contractor Address: 3701 Mallard Drive, Benicia, CA 94510
Resident Engineer: Nathaniel Steen Structure Rep.: Burrows, Jarred

Sample Information

DIME Sample ID: 2020-06-30-3
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7263
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 06/30/2020
Date that the sample was received by the laboratory/organization performing the testing: 06/30/2020
The quantity of what the sample constitutes: 2 lots of 4 formsaver assemblies
A brief description of the sample: #5 Lenton Formsaver Coupler
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Con-Fab California Corporation

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: #5
Coupler Model: FS5FES
Coating Standards: ASTM A775 epoxy
Shape of Rebar: Straight
Rebar Hoop Diameter: Unknown
Rebar Hoop Fabricator: Unknown
Coupler Component Heat/Lot Number(s): 8298218
Rebar Heat Number(s): 6014006
Rebar Size 2 :

Test Results

Test Information 1 of 3

DIME Test ID: 2020-06-30-3-1
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical/Fatique Tensile with Slip)
Verified Date: 07/01/2020
Date Tested: 07/01/2020
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: paul.lukkarila@dot.ca.gov
Organization Phone: (916) 227-7253
General Comments for this Test: Service Splice
Additional Comments When Verified:
Number of Samples Tested 1
SampleNumber of CyclesSizeMfg. Lot Number(s)Slip (inch)Area (sqin)Peak Load (lbf)Peak Stress (psi)CommentsTested By
1No. 5/16mm1-0.00140.312885393074Service Splicefsaylor
UTM 400kip
Temperature 72.00 f
Halo ID Small

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.