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Sample Record for 2022-12-15-1

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

Project Information

Project ID: 213750 DEA: 120K0224 EFIS: 1214000097 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-5-14.5/17.1
Work Description: South County Improvement Project (Phase 2 - Oso/Alicia) CONST BRIDGES, RW, SW, HMA PVMT, JPCP, DRAINAGE, AND ELECT SYSTEMS.
Location Description: ORANGE COUNTY IN MISSION VIEJO AND LAGUNA HILLS FROM 0.7 MILE SOUTH OF OSO PARKWAY OVERCROSSING TO 0.3 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING
Contractor Name: Flatiron West, Inc
Contractor Address: 1770 La Costa Meadows Drive, San Marcos, California 92078
Resident Engineer: Steven Kim Structure Rep.: Sara Soleimani

Sample Information

DIME Sample ID: 2022-12-15-1
TL Number from the TL Form:
Sample Submitted By Organization: CT - Unassigned/General Field Laboratory
Sample Organization Contact: 5625005861
Type of Sample: Authorization
Type of Material: SMTL TM7 - Epoxy Coated Dowels
Sample Taken Date: 12/15/2022
Date that the sample was received by the laboratory/organization performing the testing: 12/19/2022
The quantity of what the sample constitutes: N/A
A brief description of the sample: A775 Epoxy Coated Dowel
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: American Highway - Simplex

Material Information

Dowel Metal Heat Number: 3500028871
Dowel Epoxy Batch Number: CH2842CR
Dowel Coating Specification: ASTM A775
Dowel Size: 1.5 in
Dowel Coating Color: Green
Dowel Manufacturer: Newcor
Dowel Coater: American Highway Simplex
Release Number:
Quality Assurance Code:
Rebar Size (#):
Test results on following page(s): 2

Test Results

Test

DIME Test ID: 2022-12-15-1-1
Test Method: ASTM A884-14: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Epoxy Coating Thickness)
Verified Date: 01/05/2023
Date Tested: 12/29/2022
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 10.06
Second Bar Mean 12.2
Lower spec. limit LSL 7 mils
Upper spec. limit USL 40 mils
Total mean value 11.13
Total number of values less than LSL no data
Total number of values greater than USL no data

Test

DIME Test ID: 2022-12-15-1-2
Test Method: ASTM A884-13: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Holiday)
Verified Date: 01/05/2023
Date Tested: 12/29/2022
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