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Sample Record for 2021-05-19-3

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Project Information

Project ID: 214795 DEA: 030H3424 EFIS: 0317000153 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-99-22.6
Work Description: REPLACE BRIDGE DECK WITH PRESTRESSED CONCRETE BOX GIRDER.
Location Description: SACRAMENTO COUNTY IN SACRAMENTO AT 21ST AVENUE UNDERCROSSING
Contractor Name: BRIDGEWAY CIVIL CONSTRUCTORS, INC.
Contractor Address: 4950 Allison Parkway, # A, Vacaville, CA 95688
Resident Engineer: Howard Giang Structure Rep.: Brandon Miller

Sample Information

DIME Sample ID: 2021-05-19-3
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Couplers
Sample Taken Date: 05/19/2021
Date that the sample was received by the laboratory/organization performing the testing: 05/20/2021
The quantity of what the sample constitutes: 3 lots
A brief description of the sample: #6 Lenton form savers
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier: 24-0154
Structure name: 21st Ave Undercrossing
The fabricator/manufacturer/facility name: ConFab

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: PTS Masonry at Confab
Rebar Size: #6
Coupler Model: Formsaver
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter:
Rebar Hoop Fabricator:
Coupler Component Heat/Lot Number(s): Erico heat 201852 lot 9783 and 9809
Rebar Heat Number(s): 4105278 4101843
Rebar Size 2 : 6
Coupler Unique ID:

Test Results

Test 1 of 6

DIME Test ID: 2021-05-19-3-1
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical/Fatique Tensile with Slip)
Verified Date: 05/20/2021
Date Tested: 05/20/2021
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. 6/19mm1-0.00320.444173094842Service Splicebewing
UTM 400kip
Temperature 72.00 f
Halo ID Small

Test 2 of 6

DIME Test ID: 2021-05-19-3-2
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical/Fatique Tensile with Slip)
Verified Date: 05/20/2021
Date Tested: 05/20/2021
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. 6/19mm100.444135293981Service Splicebewing
UTM 400kip
Temperature 72.00 f
Halo ID

Test 3 of 6

DIME Test ID: 2021-05-19-3-3
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical/Fatique Tensile with Slip)
Verified Date: 05/20/2021
Date Tested: 05/20/2021
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. 6/19mm100.444121893677Service Splicebewing
UTM 400kip
Temperature 72.00 f
Halo ID

Test 4 of 6

DIME Test ID: 2021-05-19-3-4
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical/Fatique Tensile with Slip)
Verified Date: 05/20/2021
Date Tested: 05/20/2021
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. 6/19mm2-0.0030.444155394438Service Splicebewing
UTM 400kip
Temperature 72.00 f
Halo ID Small

Test 5 of 6

DIME Test ID: 2021-05-19-3-5
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical/Fatique Tensile with Slip)
Verified Date: 05/20/2021
Date Tested: 05/20/2021
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. 6/19mm200.444156694468Service Splicebewing
UTM 400kip
Temperature 72.00 f
Halo ID

Test 6 of 6

DIME Test ID: 2021-05-19-3-6
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Cyclical/Fatique Tensile with Slip)
Verified Date: 05/20/2021
Date Tested: 05/20/2021
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. 6/19mm200.444188695195Service Splicebewing
UTM 400kip
Temperature 72.00 f
Halo ID