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Sample Record for 2021-04-26-2

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Project Information

Project ID: 214355 DEA: 120K0214 EFIS: 1214000096 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-5-12.4/14.5
Work Description: South County Improvement Project (Phase 1 - Avery/Crown Valley) PLACE HMA, INSTALL CONC PAVEMENT, RETAIN WALL, MODIFY ELECT SYS. | Add one lane btwn 73 & Oso PKWY
Location Description: ORANGE COUNTY IN SAN JUAN CAPISTRANO, LAGUNA HILLS, LAGUNA NIGUEL AND MISSION VIEJO FROM 0.5 MILE SOUTH OF AVERY PARKWAY UNDERCROSSING TO 0.8 MILE NORTH OF CROWN VALLEY PARKWAY OVERCROSSING
Contractor Name: ORTIZ ENTERPRISES, INC.
Contractor Address: 6 Cushing, Suite 200, Irvine, CA 92618
Resident Engineer: Kifah Ramadan Structure Rep.: Imad Karam

Sample Information

DIME Sample ID: 2021-04-26-2
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Headed Bars
Sample Taken Date: 04/26/2021
Date that the sample was received by the laboratory/organization performing the testing: 05/13/2021
The quantity of what the sample constitutes: (4ea) #9 Heater Bars
A brief description of the sample: #9 Button head headed bars
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Integrity Rebar

Material Information

Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 1812754
Head Manufacturer Lot Number(s): A201714
Rebar Size: #9
Headed Bar Model Name: Barsplice Buttonhead BNX
Size of Head: Full Size - 9x
Head Connection Type: Crimped Head
Head Shape: Circular
Rebar Manufacturer: Vinton Steel
Head Manufacturer: Integrity Rebar
Head Fabricator: Steel Dynamic Inc
Material Standard Code: ASTM A706
Headed Bar Unique ID:

Test Results

Test 1 of 3

DIME Test ID: 2021-04-26-2-1
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 05/13/2021
Date Tested: 05/13/2021
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: Ok Necking
Test Result Compliance:
Additional Comments When Verified:
Number of Headed Bar Samples 1
Lot #Area (sqin)Peak Load (lbf)Tensile Strength (psi)CommentsTested By
119065990659Ok Neckingbewing
Temperature 72 f
UTM 400kip

Test 2 of 3

DIME Test ID: 2021-04-26-2-2
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 05/13/2021
Date Tested: 05/13/2021
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: Ok Necking
Test Result Compliance:
Additional Comments When Verified:
Number of Headed Bar Samples 1
Lot #Area (sqin)Peak Load (lbf)Tensile Strength (psi)CommentsTested By
119569495694Ok Neckingbewing
Temperature 72 f
UTM 400kip

Test 3 of 3

DIME Test ID: 2021-04-26-2-3
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 05/13/2021
Date Tested: 05/13/2021
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: Ok necking
Test Result Compliance:
Additional Comments When Verified:
Number of Headed Bar Samples 1
Lot #Area (sqin)Peak Load (lbf)Tensile Strength (psi)CommentsTested By
119341993419Ok neckingbewing
Temperature 72 f
UTM 400kip