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Sample Record for 2017-10-24-1

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

Project Information

Project ID: 212566 DEA: 120Q8604 EFIS: 1217000117 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-57-11.0/19.6
Work Description: SLAB REPLACEMENT (RSC), GRIND & GROOVE CONC PVMT, RHMA-G PVMT
Location Description: ORANGE COUNTY IN ORANGE, ANAHEIM, PLACENTIA, AND FULLERTON FROM 0.2 MILE SOUTH OF CHAPMAN AVENUE UNDERCROSSING TO ASSOCIATED ROAD UNDERCROSSING
Contractor Name: AUTOBAHN CONSTRUCTION INC.
Contractor Address: 933 N. Batavia Street, Orange, CA 92867
Resident Engineer: Adrian Wu Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2017-10-24-1
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Recertification
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 10/24/2017
Date that the sample was received by the laboratory/organization performing the testing: 10/30/2017
The quantity of what the sample constitutes: 30 shipments
A brief description of the sample: Epoxy Coated Dowels
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: J C Supply - Manufacturing

Material Information

Rebar Heat Number(s): Dowel Heat PL 16208488
Rebar Epoxy Batch Number(s):
Rebar Coating Specification: ASTM A775
Rebar Size (#): Dowel 1.5"X 18"
Rebar Coating Color: Green
Rebar Manufacturer: Dowel,Nucor
Rebar Coater: JC Supply And Manufacturing
Rebar Powder Manufacturer: Valspar
Release Number: Unknown
Quality Assurance Code: Unknown
Test results on following page(s): 2

Test Results

Test

DIME Test ID: 2017-10-24-1-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 10/31/2017
Date Tested: 10/31/2017
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 10.73
Second Bar Mean 9.47
Lower spec. limit LSL 7
Upper spec. limit USL 40
Bar # for First Bar no data
Bar # for Second Bar no data
Total mean value 10.1
Total number of values less than LSL no data
Total number of values greater than USL no data

Test

DIME Test ID: 2017-10-24-1-2
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 10/31/2017
Date Tested: 10/31/2017
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
Bend Test Pass/Fail NA