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Sample Record for 2017-07-21-1

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

Project Information

Project ID: 212352 DEA: 044K8004 QA Service Level: 1
DIST-CO-RTE-PM: 04-SCL,SCL-35-10.5, 10.50, 9.5/10.5
Work Description: Construct SOLDIER PILE AND SOIL NAIL WALLS
Location Description: IN SANTA CLARA COUNTY, NEAR LOS GATOS, AT 1.2 MILES NORTH OF LAS CUMBRES ROAD
Contractor Name: Disney Construction Inc
Contractor Address: 859 Cowan Road, Suite #3, Burlingame, CA 94010
Resident Engineer: Moaid Laymoun Structure Rep.: Arif Khan

Sample Information

DIME Sample ID: 2017-07-21-1
TL Number from the TL Form: Unknown
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 - Threaded Bar
Sample Taken Date: 07/21/2017
Date that the sample was received by the laboratory/organization performing the testing: 07/25/2017
The quantity of what the sample constitutes: unknown
A brief description of the sample: No 10 Gr 75 bar and hex nut
From where was the sample collected: Manufacturer
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Williams Form Eng

Material Information

Production or Authorization Testing: Production Testing
Threaded Bar Specification: ASTM A615
Threaded Bar Grade: 75
Threaded Bar Type: Deformed
Rebar Size: #10
Nut Specification for Threaded Bar: Grade 75 ATB
System Manufacturer: Williams Form Eng
Epoxy Coating Color: NA
Threaded Bar Application: Threaded Bar
Coating Standards: Uncoated
Bar Heat Number(s): 100884127, DL16104196
Nut Heat Number(s): 10H3D
Bar Lot Number: NA
Nut Lot Number: NA
Coupler Heat Number(s): NA
Coupler Grade: NA

Test Results

Test 1 of 4

DIME Test ID: 2017-07-21-1-1
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 07/26/2017
Date Tested: 07/25/2017
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: A615 Bar & Nut
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)CommentsTested By
1#10 Bar Heat #100884127, Nut Heat #10H5DL08072171.271155178116210.6A615 Bar & NutFred
Temperature 72 F
UTM 400KIP

Test 2 of 4

DIME Test ID: 2017-07-21-1-2
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 07/26/2017
Date Tested: 07/25/2017
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: A615 Bar & Nut
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)CommentsTested By
2#10 Bar Heat #100884127, Nut Heat #10H5DL08072171.27112962803650A615 Bar & NutFred
Temperature 72 F
UTM 400KIP

Test 3 of 4

DIME Test ID: 2017-07-21-1-3
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 07/26/2017
Date Tested: 07/25/2017
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: A615 Bar & Nut
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)CommentsTested By
3#10 Bar Heat #DL16104196, Nut Heat #10H5DL08072171.271194898141011.4A615 Bar & NutFred
Temperature 72 F
UTM 400KIP

Test 4 of 4

DIME Test ID: 2017-07-21-1-4
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 07/26/2017
Date Tested: 07/25/2017
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: A615 Bar & Nut
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)CommentsTested By
4#10 Bar Heat #DL16104196, Nut Heat #10H5DL08072171.27119404833960A615 Bar & NutFred
Temperature 72 F
UTM 400KIP