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Sample Record for 2021-05-13-7

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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: 2021-05-13-7
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 - Couplers
Sample Taken Date: 05/13/2021
Date that the sample was received by the laboratory/organization performing the testing: 05/14/2021
The quantity of what the sample constitutes: (4) LENTON FORM SAVER (Sleeve-Tapered Thread)
A brief description of the sample: LENTON FORM SAVER (Sleeve-Tapered Thread)
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Coreslab Structures L A Inc

Material Information

Production or Authorization Testing: Production Testing
Service or Ultimate: Ultimate
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: CMC Steel Arizona
Coupler Manufacturer: Erico nVent
Intermediate Assembler or Fabricator: Coreslab Structures L A Inc
Rebar Size: #8
Coupler Model: ST-17-05
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator: NA
Coupler Component Heat/Lot Number(s): L9814
Rebar Heat Number(s): 4102817
Rebar Size 2 : 8
Coupler Unique ID:

Test Results

Test 1 of 3

DIME Test ID: 2021-05-13-7-1
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical/Fatique Tensile with Slip)
Verified Date: 05/18/2021
Date Tested: 05/14/2021
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: Service Splice
Test Result Compliance:
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. 8/25mm1-0.0020.797605696274Service Splicefsaylor
UTM 400kip
Temperature 72.00 f
Halo ID Small

Test 2 of 3

DIME Test ID: 2021-05-13-7-2
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical/Fatique Tensile with Slip)
Verified Date: 05/18/2021
Date Tested: 05/14/2021
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: Service Splice
Test Result Compliance:
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
2No. 8/25mm100.797765998302Service Splicefsaylor
UTM 400kip
Temperature 72.00 f
Halo ID

Test 3 of 3

DIME Test ID: 2021-05-13-7-3
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical/Fatique Tensile with Slip)
Verified Date: 05/18/2021
Date Tested: 05/14/2021
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: Service Splice
Test Result Compliance:
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
3No. 8/25mm100.797709797591Service Splicefsaylor
UTM 400kip
Temperature 72.00 f
Halo ID