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Sample Record for 2023-04-25-1

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

Project Information

Project ID: 77777 DEA: CHEM-STOCK EFIS: CHEM-STOCK QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for Chem Lab stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2023-04-25-1
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: 04/25/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/08/2023
The quantity of what the sample constitutes: 3
A brief description of the sample: ASTMA775 epoxy coated dowels
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: American Highway - Simplex

Material Information

Dowel Metal Heat Number: 1202048045
Dowel Epoxy Batch Number: CH0483ZS
Dowel Coating Specification: ASTM A884
Dowel Size: 1.5 in
Dowel Coating Color: Green
Dowel Manufacturer: Nucor
Dowel Coater: American Highway Simplex
Release Number:
Quality Assurance Code:
Rebar Size (#):
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2023-04-25-1-1
Test Method: ASTM A884-19e20: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Epoxy Coating Thickness)
Verified Date: 05/11/2023
Date Tested: 05/11/2023
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 11.14
Second Bar Mean 9.37
Lower spec. limit LSL 7 mils
Upper spec. limit USL 40 mils
Total mean value 10.25
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: 2023-04-25-1-2
Test Method: ASTM A884-19e20: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Holiday)
Verified Date: 05/11/2023
Date Tested: 05/11/2023
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 no data0
Total Length 5
Holidays Per Linear Foot of Bar no data0 holiday per ft
Holiday Test Pass/Fail Pass