Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 993318 DEA: 11423704 EFIS: 1116000059
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-8-R31.8/R41.7
Work Description: PLACE CRCP, HMA, MGS, AND WATER POLLUTION CONTROL SYSTEM.
Location Description: SAN DIEGO COUNTY NEAR ALPINE FROM VIEJAS CREEK BRIDGE TO PINE VALLEY CREEK BRIDGE
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 5860 El Camino Real, Ste 200, Carlsbad, CA 92008
Resident Engineer: Art Pannu Structure Rep.: Carlos Guzman
DIME Sample ID: 2024-09-05-37
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (530) 329-6527
Type of Sample: Quality Assurance
Type of Material: SMTL TM7 - Epoxy Coated Dowels
Sample Taken Date: 09/05/2024
Date that the sample was received by the laboratory/organization performing the testing: 09/06/2024
The quantity of what the sample constitutes: 505
A brief description of the sample: Epoxy Coated Dowel
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: American Highway
Dowel Metal Heat Number: 1202062387
Dowel Epoxy Batch Number: CH2613TV CH0684UP
Dowel Coating Specification: ASTM A884
Dowel Size: 1.5 in
Dowel Coating Color: Purple
Dowel Manufacturer: Nucor
Dowel Coater: American Highway
Release Number:
Quality Assurance Code:
Rebar Size (#):
