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Sample Record for 2017-07-28-5

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

Project Information

Project ID: 211931 DEA: 043G6414 EFIS: 0416000348 QA Service Level: 1
DIST-CO-RTE-PM: 04-NAP-29-37.0
Work Description: SCOUR REPLACE BRIDGE
Location Description: NAPA COUNTY IN CALISTOGA AT NAPA RIVER BRIDGE
Contractor Name: Valentine Corp.
Contractor Address: 111 Pelican Way, San Rafael, CA 94901
Resident Engineer: Danilo Patenia Structure Rep.: Nana Budu

Sample Information

DIME Sample ID: 2017-07-28-5
TL Number from the TL Form: C647233
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: 07/28/2017
Date that the sample was received by the laboratory/organization performing the testing: 08/01/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: Epoxy Coated Threadbar
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Williams Form

Material Information

Production or Authorization Testing: Production Testing
Threaded Bar Specification: ASTM A615
Threaded Bar Grade: 75
Threaded Bar Type: Deformed
Rebar Size: 9
Nut Specification for Threaded Bar: unknown
System Manufacturer: Williams Form
Epoxy Coating Color: Purple
Threaded Bar Application: Soil Nail
Coating Standards: ASTM A934 epoxy
Bar Heat Number(s): 100786966
Nut Heat Number(s):
Bar Lot Number:
Nut Lot Number: 9H7D
Coupler Heat Number(s):
Coupler Grade:

Test Results

Test 1 of 2

DIME Test ID: 2017-07-28-5-1
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 08/02/2017
Date Tested: 08/01/2017
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 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#9 Williams Bar, Testing NutL73007171127856990910A615 NutFred
Temperature 72 F
UTM 400KIP

Test 2 of 2

DIME Test ID: 2017-07-28-5-2
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 08/02/2017
Date Tested: 08/01/2017
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 11.84 mils
Second Bar Mean 15.22 mils
Lower spec. limit LSL 10 mils
Upper spec. limit USL 15 mils
Bar # for First Bar no data
Bar # for Second Bar no data
Total mean value 13.53 mils
Total number of values less than LSL no data
Total number of values greater than USL no data