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Sample Record for 2017-07-20-11

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

Project Information

Project ID: 211070 DEA: 080Q3004 EFIS: 0800020191 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-138-R17.1/R19.2
Work Description: REALIGN SECTION OF STATE ROUTE 138
Location Description: Near Hesperia from 1.9 mi East of Route 15 to 0.1 mi West of Summit Post Office Road to realign sections of State Route 138
Contractor Name: Skanska Civil USA
Contractor Address: 1995 Agua Mansa Road, Riverside, CA 92509
Resident Engineer: Amgad Benjamin Structure Rep.: Tim Flores

Sample Information

DIME Sample ID: 2017-07-20-11
TL Number from the TL Form: C719141
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (530) 329-6527
Type of Sample: Quality Assurance
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 07/20/2017
Date that the sample was received by the laboratory/organization performing the testing: 07/25/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: Epoxy Coated Rebar
From where was the sample collected: Distributor
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Western Coating

Material Information

Rebar Heat Number(s): 4067179
Rebar Epoxy Batch Number(s): TD95852NA
Rebar Coating Specification: ASTM A775
Rebar Size (#): 5
Rebar Coating Color: Green
Rebar Manufacturer: CMC
Rebar Coater: Western Coating
Rebar Powder Manufacturer: Unknown
Release Number: Unknown
Quality Assurance Code: Unknown
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2017-07-20-11-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
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:
Test Result Compliance:
Additional Comments When Verified:
First Bar Mean 9.15 mils
Second Bar Mean 9 mils
Lower spec. limit LSL 7 mils
Upper spec. limit USL 12 mils
Bar # for First Bar no data
Bar # for Second Bar no data
Total mean value 9.07 mils
Total number of values less than LSL no data
Total number of values greater than USL no data

Test 2 of 2

DIME Test ID: 2017-07-20-11-2
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
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:
Test Result Compliance:
Additional Comments When Verified:
Total Number of Holiday 0
Total Length 5 ft
Holidays Per Linear Foot of Bar 0 holiday pe
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass