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Sample Record for 2025-08-19-5

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

Project Information

Project ID: 1000612 DEA: 120R57U4 EFIS: 1223000131 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-405-11.4/24.2
Work Description: PLACE JPCP (RSC) AND RHMA, AND MODIFY ELECTRICAL SYSTEMS.
Location Description: ORANGE COUNTY FROM HARBOR BOULEVARD UNDERCROSSING IN COSTA MESA TO LOS ANGELES COUNTY LINE AT ROSSMOOR
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 9050 Norris Ave. #200, Westlake Village, CA 91361
Resident Engineer: Dennis Nguyen Structure Rep.: maribel Munoz Blanco

Sample Information

DIME Sample ID: 2025-08-19-5
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: Quality Assurance
Type of Material: SMTL TM7 - Epoxy Coated Dowels
Sample Taken Date: 08/19/2025
Date that the sample was received by the laboratory/organization performing the testing: 08/21/2025
The quantity of what the sample constitutes: 8064
A brief description of the sample: 1.5"x18" Baskets
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Highway Products

Material Information

Dowel Metal Heat Number: 4400038876 4400038059 4400038877 4400038058 4400037190
Dowel Epoxy Batch Number: CH2424PC AL63996NA
Dowel Coating Specification: ASTM A884
Dowel Size: 1.5 in
Dowel Coating Color: Green
Dowel Manufacturer: Nucor
Dowel Coater: Simcote
Release Number: L196-003-25
Quality Assurance Code: L196
Rebar Size (#):
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2025-08-19-5-1
Test Method: ASTM A884-19e20: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Epoxy Coating Thickness)
Verified Date: 09/08/2025
Date Tested: 09/08/2025
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 13.19
Second Bar Mean 16.97
Lower spec. limit LSL 7 mils
Upper spec. limit USL 40 mils
Total mean value 15.08
Total number of values less than LSL no data
Total number of values greater than USL no data

Test 2 of 2

DIME Test ID: 2025-08-19-5-2
Test Method: ASTM A884-19e20: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Holiday)
Verified Date: 09/08/2025
Date Tested: 09/08/2025
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 no data0
Total Length 3
Holidays Per Linear Foot of Bar no data0 holiday per ft
Holiday Test Pass/Fail Pass