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Sample Record for 2020-05-01-1

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Project Information

Project ID: 214190 DEA: 024G41U4 EFIS: 0218000047 QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS,SIS-5-Var
Work Description: REPLACE REINFORCED CONCRETE BRIDGES & CONSTRUCT RETAINING WALL.
Location Description: SHASTA AND SISKIYOU COUNTIES ABOUT 7 MILES NORTH OF POLLARD FLAT FROM 0.8 MILE SOUTH TO 0.7 MILE NORTH OF SIMS ROAD UNDERCROSSING AND FROM 0.6 MILE SOUTH OF CASTLE CRAGS DRIVE UNDERCROSSING TO 0.2 MILE SOUTH OF SOUTH DUNSMUIR UNDERCROSSING
Contractor Name: J.F. Shea Construction, Inc.
Contractor Address: 17400 Clear Creek Road, Redding, CA 96001
Resident Engineer: Nicole Mallory Structure Rep.: Adam Scardaci

Sample Information

DIME Sample ID: 2020-05-01-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Acceptance
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 05/01/2020
Date that the sample was received by the laboratory/organization performing the testing: 05/07/2020
The quantity of what the sample constitutes: 881lbs
A brief description of the sample: #4 ASTM A775 Epoxy Coated Rebar
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Western Coatings

Material Information

Rebar Heat Number(s): 067720
Rebar Epoxy Batch Number(s): 3CH1936010
Rebar Coating Specification: ASTM A775
Rebar Size (#): 4
Rebar Coating Color: Green
Rebar Manufacturer: Cascade
Rebar Coater: Western Coating Eugene OR
Rebar Powder Manufacturer: Valspar
Release Number: 45854
Quality Assurance Code: Unknown
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2020-05-01-1-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 05/11/2020
Date Tested: 05/07/2020
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 30
Holidays Per Linear Foot of Bar 0
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass

Test 2 of 2

DIME Test ID: 2020-05-01-1-2
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 05/11/2020
Date Tested: 05/07/2020
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 9.46
Second Bar Mean 10.14
Lower spec. limit LSL 7
Upper spec. limit USL 12
Bar # for First Bar 1
Bar # for Second Bar 2
Total mean value 9.8
Total number of values less than LSL no data
Total number of values greater than USL no data