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Sample Record for 2019-12-16-2

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Project Information

Project ID: 213750 DEA: 120K0224 EFIS: 1214000097 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-5-14.5/17.1
Work Description: South County Improvement Project (Phase 2 - Oso/Alicia) CONST BRIDGES, RW, SW, HMA PVMT, JPCP, DRAINAGE, AND ELECT SYSTEMS.
Location Description: ORANGE COUNTY IN MISSION VIEJO AND LAGUNA HILLS FROM 0.7 MILE SOUTH OF OSO PARKWAY OVERCROSSING TO 0.3 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING
Contractor Name: Flatiron West, Inc
Contractor Address: 1770 La Costa Meadows Drive, San Marcos, California 92078
Resident Engineer: Steven Kim Structure Rep.: Sara Soleimani

Sample Information

DIME Sample ID: 2019-12-16-2
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Acceptance
Type of Material: SMTL TM5 - Threaded Bar
Sample Taken Date: 12/16/2019
Date that the sample was received by the laboratory/organization performing the testing: 12/20/2019
The quantity of what the sample constitutes: 2
A brief description of the sample: 8 ASTM A615 Grade 75 Bare Threaded Bars
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Williams Form Engineering

Material Information

Production or Authorization Testing: Authorization Testing
Threaded Bar Specification: ASTM A615
Threaded Bar Grade: 75
Threaded Bar Type: Deformed
Rebar Size: 8
Nut Specification for Threaded Bar: ASTM A108
System Manufacturer: Williams Form Engineering
Epoxy Coating Color: NA
Threaded Bar Application: Soil Nail
Coating Standards: Uncoated
Bar Heat Number(s): 100896013, 100202022
Nut Heat Number(s): 8299543
Bar Lot Number: 10089601320, 10020202220
Nut Lot Number:
Coupler Heat Number(s): NA
Coupler Grade: NA

Test Results

Test 1 of 4

DIME Test ID: 2019-12-16-2-1
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 12/30/2019
Date Tested: 12/30/2019
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 Threaded Bar and 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
No.8/25mm0.79124981926430A615 Threaded Bar and Nutbewing
Temperature 72 f
UTM 400kip

Test 2 of 4

DIME Test ID: 2019-12-16-2-2
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 12/30/2019
Date Tested: 12/30/2019
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 Threaded Bar and 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
No.8/25mm0.79124120937757.34A615 Threaded Bar and Nutbewing
Temperature 72 f
UTM 400kip

Test 3 of 4

DIME Test ID: 2019-12-16-2-3
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 12/30/2019
Date Tested: 12/30/2019
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 Threaded Bar and 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
No.8/25mm0.79122580951390A615 Threaded Bar and Nutbewing
Temperature 72 f
UTM 400kip

Test 4 of 4

DIME Test ID: 2019-12-16-2-4
Test Method: ASTM A615-15: Standard Specification for Deformed and Plain Carbon-Steel Bars for Concrete Reinforcement (Tensile)
Verified Date: 12/30/2019
Date Tested: 12/30/2019
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 Threaded Bar and 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
No.8/25mm0.79121858947198.44A615 Threaded Bar and Nutbewing
Temperature 72 f
UTM 400kip