Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002077 DEA: 033H5904 EFIS: 0318000017
QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-80-R26.3/R55.2
Work Description:
Location Description:
Contractor Name: Flatiron Dragados/Teichert
Contractor Address: 555 S Auburn St, Colfax, CA 95713
Resident Engineer: John Ruzic Structure Rep.: Carl Anderson
DIME Sample ID: 2026-08-06-16
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: 08/06/2026
Date that the sample was received by the laboratory/organization performing the testing: 08/10/2026
The quantity of what the sample constitutes: 406 LF
A brief description of the sample: ASTM A934 1 ½” X 18” FULLY EPOXY COATED PURPLE DOWEL BAR BASKETS (7 BAR 13.2” PAVE)
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: American Higway
Dowel Metal Heat Number: 1201075238
Dowel Epoxy Batch Number: CH3005KW CH0436JF
Dowel Coating Specification: ASTM A934
Dowel Size: 1.5 in
Dowel Coating Color: Purple
Dowel Manufacturer: Nucor
Dowel Coater: American Highway
Release Number:
Quality Assurance Code:
Rebar Size (#):
DIME Test ID: 2026-08-06-16-1
Test Method: ASTM A934-19: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Epoxy-Coating)
Verified Date: 08/20/2026
Date Tested: 08/20/2026
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: complies
Additional Comments When Verified:
|
Lower spec. limit LSL
|
7 mils
|
|
Upper spec. limit USL
|
12 mils
|
|
Bar # for First Bar
|
1
|
|
Bar # for Second Bar
|
2
|
|
First Bar Mean
|
8.3
|
|
Second Bar Mean
|
9.2
|
|
Total mean value
|
8.75
|
DIME Test ID: 2026-08-06-16-2
Test Method: ASTM A934-19: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Holiday Bend)
Verified Date: 08/20/2026
Date Tested: 08/20/2026
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: complies
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
|
