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Testing Report for 2018-10-08-1-2

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

Project Information

Project ID: 212600 DEA: 07293704 EFIS: 0713000239 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-110,405-8.0/9.0,12.2/13.2
Work Description: WIDEN SHOULDER AND AUXILIARY LANE OF CONNECTOR.
Location Description: LOS ANGELES COUNTY IN AND NEAR CARSON ON ROUTE 110 FROM 0.2 MILE NORTH OF TORRANCE BOULEVARD UNDERCROSSING TO 190TH STREET UNDERCROSSING AND ON ROUTE 405 FROM MAIN STREET UNDERCROSSING TO 190TH STREET UNDERCROSSING
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: SAM GALLARDO Structure Rep.: Gregory R. Alexander

Sample Information

DIME Sample ID: 2018-10-08-1
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT QASI - Los Angeles Field Laboratory
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM5 - Threaded Bar
Sample Taken Date: 10/08/2018
Date that the sample was received by the laboratory/organization performing the testing: 10/10/2018
The quantity of what the sample constitutes: 2
A brief description of the sample: Thread Bar Nuts
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Williams Form Engineering-SD

Material Information

Production or Authorization Testing: Authorization Testing
Threaded Bar Specification: ASTM A615
Threaded Bar Grade: 75
Threaded Bar Type:
Rebar Size: 9
Nut Specification for Threaded Bar: XXXXX
System Manufacturer: Williams Form Engineering
Epoxy Coating Color: NA
Threaded Bar Application: Threaded Bar
Coating Standards: Uncoated
Bar Heat Number(s): PL16207196
Nut Heat Number(s): 8296508
Bar Lot Number: NA
Nut Lot Number: 9J1D
Coupler Heat Number(s): NA
Coupler Grade: NA

Test Information

DIME Test ID: 2018-10-08-1-1
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 10/16/2018
Date Tested: 10/11/2018
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: paul.lukkarila@dot.ca.gov
Organization Phone: (916) 227-7253
General Comments for this Test: A615 Threaded Bar and Nut
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Number of Samples 1
SampleSizeMfg LotArea (sqin)Tensile Strength (psi)Stress at Offset (psi)Total Elongation (%)CommentsTested By
2#9 Bar Heat # PL16207196, Nut Lot # 9J1DL79-077-181109801809770A615 Threaded Bar and NutBrian
Temperature 72 F
UTM 400KIP