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Sample Record for 2020-07-17-1

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

Project Information

Project ID: 214466 DEA: 081F1414 EFIS: 0815000231 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-15-15-54.2/54.3
Work Description: Slab & lane replacement with JPCP & precast conc pavement, place HMA.
Location Description: Riverside and San Diego County
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 Townsgate Road, Suite 200, Westlake Village, CA 91361
Resident Engineer: Mike Bergevin Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2020-07-17-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Quality Assurance
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 07/17/2020
Date that the sample was received by the laboratory/organization performing the testing: 07/20/2020
The quantity of what the sample constitutes: 2 bars plus 1 blast bar
A brief description of the sample: #6 Epoxy coated Tie Bar Baskets
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Simplex - Fernley, NV

Material Information

Rebar Heat Number(s): 1202019841
Rebar Epoxy Batch Number(s): 3CH2013021
Rebar Coating Specification: ASTM A775
Rebar Size (#): 6
Rebar Coating Color: Green
Rebar Manufacturer: Nucor
Rebar Coater: Simplex Fernley NV
Rebar Powder Manufacturer: Sherwin Williams
Release Number:
Quality Assurance Code:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2020-07-17-1-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 07/21/2020
Date Tested: 07/21/2020
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 5
Holidays Per Linear Foot of Bar 0
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail Pass

Test 2 of 2

DIME Test ID: 2020-07-17-1-2
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 07/21/2020
Date Tested: 07/21/2020
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 13.16
Second Bar Mean 14.38
Lower spec. limit LSL 7
Upper spec. limit USL 16
Bar # for First Bar 1
Bar # for Second Bar 1
Total mean value 13.77
Total number of values less than LSL no data
Total number of values greater than USL no data