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Sample Record for 2021-07-30-2

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Project Information

Project ID: 215753 DEA: 050N72U4 EFIS: 0520000169 QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-4.4/R7.7
Work Description: Please cc Office Engineer Ni Nyoman Paul on reports sent to RE and SR. Construct High Occupancy Vehicle (HOV) lanes on U.S. Route 101 and rehabilitation - Segment 4B.
Location Description: 101 freeway in Summerland, CA
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 5335 Debbie Road, Santa Barbara, CA 93111
Resident Engineer: Luobao Cai Structure Rep.: Emiliano Berntsen

Sample Information

DIME Sample ID: 2021-07-30-2
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: 07/30/2021
Date that the sample was received by the laboratory/organization performing the testing: 08/03/2021
The quantity of what the sample constitutes: 4
A brief description of the sample: #11 Headed Reinforcements
From where was the sample collected: Source
Laboratory sample identification: L124-50-21
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: HRC

Material Information

Production or Authorization Testing: Production Testing
Rebar Heat Number(s): 4108404
Head Manufacturer Lot Number(s): 1
Rebar Size: #11
Headed Bar Model Name: HRC 120
Size of Head: Full Size - 9x
Head Connection Type: Friction Weld
Head Shape: Square
Rebar Manufacturer: CMC Rebar
Head Manufacturer: HRC
Head Fabricator: HRC
Material Standard Code: ASTM A615
Headed Bar Unique ID:

Test Results

Test 1 of 3

DIME Test ID: 2021-07-30-2-1
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 08/04/2021
Date Tested: 08/04/2021
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
11.5614558293322OK Neckingfsaylor
Temperature 72 f
UTM 400kip

Test 2 of 3

DIME Test ID: 2021-07-30-2-2
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 08/04/2021
Date Tested: 08/04/2021
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
11.5614656193949OK Neckingfsaylor
Temperature 72 f
UTM 400kip

Test 3 of 3

DIME Test ID: 2021-07-30-2-3
Test Method: ASTM A970-15e1: Standard Specification for Headed Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 08/04/2021
Date Tested: 08/04/2021
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
11.5614624993749OK Neckingfsaylor
Temperature 72 f
UTM 400kip