Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000576 DEA: 120R3134 EFIS: 1220000025
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-91-6.4/R9.2
Work Description: PLACE JPCP, REMOVE CONC PVMT AND BASE, AND MODIFY ELECTRICAL SYSTEMS.
Location Description: ORANGE COUNTY IN ANAHEIM FROM 0.3 MILE EAST OF ROUTE 91/57 SEPARATION TO 0.1 MILE EAST OF ROUTE 91/55 SEPARATION
Contractor Name: PETERSON-CHASE GENERAL ENGINEERING CONSTRUCTION, INC.
Contractor Address: Unknown
Resident Engineer: Clay Walker Structure Rep.: Matthew Chang
DIME Sample ID: 2025-10-16-4
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 Dowels
Sample Taken Date: 10/16/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/21/2025
The quantity of what the sample constitutes: 1250 pcs Dowel Bar Baskets
A brief description of the sample: 1.5" x 18" @12" OC Dowel Bar Baskets
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Pacific Highway Products
Dowel Metal Heat Number: Dowel Heat 4400038058, 4400038061 Wire Heat 965320
Dowel Epoxy Batch Number: CH1255YE
Dowel Coating Specification: ASTM A775
Dowel Size: 1.5 in
Dowel Coating Color: Green
Dowel Manufacturer: Nucor Steel
Dowel Coater: Simcote Inc
Release Number:
Quality Assurance Code:
Rebar Size (#):
DIME Test ID: 2025-10-16-4-1
Test Method: ASTM A884-19e20: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Epoxy Coating Thickness)
Verified Date: 10/23/2025
Date Tested: 10/23/2025
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: brian.ellis@dot.ca.gov
Organization Phone: (916) 380-8623
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
|
First Bar Mean
|
9.44
|
|
Second Bar Mean
|
10.98
|
|
Lower spec. limit LSL
|
7 mils
|
|
Upper spec. limit USL
|
40 mils
|
|
Total mean value
|
10.21
|
|
Total number of values less than LSL
|
no data
|
|
Total number of values greater than USL
|
no data
|
DIME Test ID: 2025-10-16-4-2
Test Method: ASTM A884-19e20: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Holiday)
Verified Date: 10/23/2025
Date Tested: 10/23/2025
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: brian.ellis@dot.ca.gov
Organization Phone: (916) 380-8623
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
|
