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Sample Record for 2018-11-15-5

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

Project Information

Project ID: 212376 DEA: 044G8504 EFIS: 0413000052 QA Service Level: 1
DIST-CO-RTE-PM: 04-SM-1-R44.1
Work Description: REPLACE PEDESTRIAN OVERCROSSING
Location Description: SAN MATEO COUNTY IN PACIFICA AT THE SAN JOSE AVENUE PEDESTRIAN OVERCROSSING
Contractor Name: BRIDGEWAY CIVIL CONSTRUCTORS, INC.
Contractor Address: 4950 Allison Parkway, # A, Vacaville, CA 95866
Resident Engineer: Jose Mario David Structure Rep.: Jason Louie

Sample Information

DIME Sample ID: 2018-11-15-5
TL Number from the TL Form: C794241
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 TM5 - Couplers
Sample Taken Date: 11/15/2018
Date that the sample was received by the laboratory/organization performing the testing: 11/15/2018
The quantity of what the sample constitutes: 4
A brief description of the sample: Couplers
From where was the sample collected: Job Site
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Gerdau, HRC

Material Information

Production or Authorization Testing: Production Testing
Service or Ultimate: Service
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Manufacturer: Gerdau
Coupler Manufacturer: HRC
Intermediate Assembler or Fabricator: Unknown
Rebar Size: 9
Coupler Model: 500 510
Coating Standards: Uncoated
Shape of Rebar: Straight
Rebar Hoop Diameter: Unknown
Rebar Hoop Fabricator: Unknown
Coupler Component Heat/Lot Number(s): 177275, A180128
Rebar Heat Number(s): 65032488 02
Rebar Size 2 :
Coupler Unique ID:

Test Results

Test 1 of 3

DIME Test ID: 2018-11-15-5-1
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 11/16/2018
Date Tested: 11/16/2018
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: Service Splice
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleMfg. Lot Number(s)SizeArea (sqin)Slip (inch)Peak Load (lbf)Peak Stress (psi)CommentsTested By
11#9/29mm1-0.00229736097360Service SpliceBrian
Temperature 72 F
UTM 400KIP
Halo ID Small

Test 2 of 3

DIME Test ID: 2018-11-15-5-2
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 11/16/2018
Date Tested: 11/16/2018
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: Service Splice
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleMfg. Lot Number(s)SizeArea (sqin)Slip (inch)Peak Load (lbf)Peak Stress (psi)CommentsTested By
21#9/29mm10100430100430Service SpliceBrian
Temperature 72 F
UTM 400KIP
Halo ID Small

Test 3 of 3

DIME Test ID: 2018-11-15-5-3
Test Method: CTM 670-December 2013: Method of Tests for Mechanical and Welded Reinforcing Steel Splices (Tensile Slip)
Verified Date: 11/16/2018
Date Tested: 11/16/2018
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: Service Splice
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleMfg. Lot Number(s)SizeArea (sqin)Slip (inch)Peak Load (lbf)Peak Stress (psi)CommentsTested By
21#9/29mm109932999329Service SpliceBrian
Temperature 72 F
UTM 400KIP
Halo ID Small