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Sample Record for 2021-06-28-1

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Project Information

Project ID: 213099 DEA: 041A6614 EFIS: 0415000291 COOP: 042683A1 QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN-101-8.4
Work Description: CONSTRUCTION ON STATE HIGHWAY IN MARIN COUNTY IN LARKSPUR
Location Description:
Contractor Name: Disney Construction
Contractor Address: 533 airport Blvd, Suite 120, Burlingame, CA 94010
Resident Engineer: Steven Russell Structure Rep.: Long Ly

Sample Information

DIME Sample ID: 2021-06-28-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Acceptance
Type of Material: SMTL TM5 - Threaded Bar
Sample Taken Date: 06/28/2021
Date that the sample was received by the laboratory/organization performing the testing: 07/07/2021
The quantity of what the sample constitutes: 15
A brief description of the sample: 1.0"x 48" all thread bars
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Schwager Davis

Material Information

Production or Authorization Testing: Authorization Testing
Threaded Bar Specification: ASTM A722
Threaded Bar Grade: 722
Threaded Bar Type: Plain
Rebar Size:
Nut Specification for Threaded Bar: A29
System Manufacturer: Gerdau
Epoxy Coating Color: NA
Threaded Bar Application: Threaded Bar
Coating Standards: Uncoated
Bar Heat Number(s): 62150104
Nut Heat Number(s): 8298147
Bar Lot Number: 2080450
Nut Lot Number: 2080618
Coupler Heat Number(s):
Coupler Grade:

Test Results

Test 1 of 2

DIME Test ID: 2021-06-28-1-1
Test Method: ASTM A722-15: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
Verified Date: 07/09/2021
Date Tested: 07/08/2021
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: A722 Bar and Nut
Test Result Compliance:
Additional Comments When Verified:
Number of Threaded Bar Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)Reduction of area (%)CommentsTested By
1ASTM A722 Type II Deformed Bar 1 : 26mm621501040.794161441.68137.73033.4A722 Bar and Nutbewing
Temperature 72 f
UTM 400kip

Test 2 of 2

DIME Test ID: 2021-06-28-1-2
Test Method: ASTM A722-15: Standard Specification for High-Strength Steel Bars for Prestressed Concrete (Tensile)
Verified Date: 07/09/2021
Date Tested: 07/08/2021
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: A722 Bar
Test Result Compliance:
Additional Comments When Verified:
Number of Threaded Bar Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)Reduction of area (%)CommentsTested By
2ASTM A722 Type II Deformed Bar 1 : 26mm621501040.85169745.08136.018.98100A722 Barbewing
Temperature 72 f
UTM 400kip