Project Information

Project ID: 1001201 DEA: 120S5304 EFIS: 1220000087 QA Service Level: 1

DIST-CO-RTE-PM: 12-ORA-57-15.9

Work Description: PLACE JPCP (RSC) AND HMA, MODIFY RAMP AND ELECTRICAL SYSTEMS.

Location Description: ORANGE COUNTY IN ANAHEIM AT SOUTHBOUND ROUTE 57 OFF-RAMP TO WESTBOUND ROUTE 91

Contractor Name: GRANITE CONSTRUCTION COMPANY

Contractor Address: Unknown

Resident Engineer: Jose Berrios Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2025-12-16-3

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: 12/16/2025

Date that the sample was received by the laboratory/organization performing the testing: 12/16/2025

The quantity of what the sample constitutes: 200 EA

A brief description of the sample: 1.5"x 18" Loose Dowels

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: 4400037190

Dowel Epoxy Batch Number: AL63996NA

Dowel Coating Specification: ASTM A775

Dowel Size: 1.5 in

Dowel Coating Color: Green

Dowel Manufacturer: Nucor

Dowel Coater: Simcote

Release Number:

Quality Assurance Code:

Rebar Size (#):

Test Results

Test 1 of 2

DIME Test ID: 2025-12-16-3-1

Test Method: ASTM A775-19: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)

Verified Date: 01/05/2026

Date Tested: 01/05/2026

Submitted By Organization: Kleinfelder - Rancho Cordova

Organization Address: 3130 Kilgore Road,

Organization City: Rancho Cordova

Organization State: CA

Organization Zipcode: 95670

Organization Email: mmlee@kleinfelder.com

Organization Phone: (916) 308-3701

General Comments for this Test:

Test Result Compliance: complies

Additional Comments When Verified:

First Bar Mean	7.15
Second Bar Mean	8.93
Lower spec. limit LSL	7
Upper spec. limit USL	12
Bar # for First Bar	1
Bar # for Second Bar	2
Total mean value	8.04
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: 2025-12-16-3-2

Test Method: ASTM A775-19: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)