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Sample Record for 2021-05-19-4

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

Project Information

Project ID: 215063 DEA: 032F5704 EFIS: 0300020615 QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-80-46.3/63.5
Work Description: Replace 4 Bridges (OC) on Highway 80 from Crystal Springs to Cisco Grove (Baxter, Drum Forebay)
Location Description:
Contractor Name: Walsh Construction Company II, LLC (Walsh)
Contractor Address: 1390 Willow Pass Road Suite 950, Concord, CA 94520
Resident Engineer: Tad Sampson Structure Rep.: Jimmer Ross

Sample Information

DIME Sample ID: 2021-05-19-4
TL Number from the TL Form: na
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 05/19/2021
Date that the sample was received by the laboratory/organization performing the testing: 05/24/2021
The quantity of what the sample constitutes: Sample testing for audit findings
A brief description of the sample: # 8 Epoxy Coated Audit Sample
From where was the sample collected: Manufacturer
Laboratory sample identification: na
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Western Coatings Ogden, UT

Material Information

Rebar Heat Number(s): 1202031306 1201031565
Rebar Epoxy Batch Number(s): C210835
Rebar Coating Specification: ASTM A775
Rebar Size (#): 8
Rebar Coating Color: Green
Rebar Manufacturer: Nucor
Rebar Coater: Western Coating Ogden UT
Rebar Powder Manufacturer: Pureflex Green
Release Number: ERSS332252SS-FH9
Quality Assurance Code:

Test Results

Test 1 of 2

DIME Test ID: 2021-05-19-4-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 05/26/2021
Date Tested: 05/24/2021
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:
Test Result Compliance:
Additional Comments When Verified:
Total Number of Holiday 0
Total Length 5
Holidays Per Linear Foot of Bar 0
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass

Test 2 of 2

DIME Test ID: 2021-05-19-4-2
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 05/26/2021
Date Tested: 05/24/2021
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:
Test Result Compliance:
Additional Comments When Verified:
First Bar Mean 9.41
Second Bar Mean 10.81
Lower spec. limit LSL 7
Upper spec. limit USL 16
Bar # for First Bar 1
Bar # for Second Bar 2
Total mean value 10.11
Total number of values less than LSL no data
Total number of values greater than USL no data