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: 2025-10-24-21
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: SMTL TM7 - Epoxy Coated Dowels
Sample Taken Date: 10/24/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/28/2025
The quantity of what the sample constitutes: 1900 pcs Dowel Bar
A brief description of the sample: 1.5" x 18" Dowel Bar
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 4400038063
Dowel Epoxy Batch Number: BC28226NA
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: 2025-10-24-21-1
Test Method: ASTM A884-19e20: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Epoxy Coating Thickness)
Verified Date: 11/06/2025
Date Tested: 11/06/2025
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
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10.15
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|
Second Bar Mean
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11.34
|
|
Lower spec. limit LSL
|
7 mils
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Upper spec. limit USL
|
40 mils
|
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Total mean value
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10.75
|
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Total number of values less than LSL
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no data
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Total number of values greater than USL
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no data
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DIME Test ID: 2025-10-24-21-2
Test Method: ASTM A884-19e20: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Holiday)
Verified Date: 11/06/2025
Date Tested: 11/06/2025
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
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no data0
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Total Length
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3
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|
Holidays Per Linear Foot of Bar
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no data0 holiday per ft
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|
Holiday Test Pass/Fail
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Pass
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