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Sample Record for 2017-04-27-4

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

Project Information

Project ID: 209732 DEA: 072881U4 EFIS: 0714000085 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-210-R16.1/R25.8
Work Description: CONSTRUCT CONCRETE PAVEMENT, PRECAST CONCRETE PANELS, AND SLABS.
Location Description: LOS ANGELES COUNTY IN LA CANADA FLINTRIDGE, GLENDALE AND PASADENA FROM DUNSMORE AVENUE UNDERCROSSING TO NORTH LOS ROBLES AVENUE OVERCROSSING
Contractor Name: FLATIRON WEST, INC.
Contractor Address: 1770 LA COSTA MEADOWS DRIVE, SAN MARCOS, CA 92078
Resident Engineer: Sushil Chaudhari Structure Rep.: Mark Amorsolo

Sample Information

DIME Sample ID: 2017-04-27-4
TL Number from the TL Form: C648371
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: 04/27/2017
Date that the sample was received by the laboratory/organization performing the testing: 05/02/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: Epoxy Coated Dowel
From where was the sample collected: Manufacturer
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: JC Supply Manufacturing

Material Information

Dowel Metal Heat Number: PL16205317
Dowel Epoxy Batch Number: 6T96023207
Dowel Coating Specification: ASTM A775
Dowel Size: 1.5 in
Dowel Coating Color: Green
Dowel Manufacturer: JC Supply And Manufacturing
Dowel Coater: JC Supply And Manufacturing
Release Number: Unknown
Quality Assurance Code: Unknown
Rebar Size (#):
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2017-04-27-4-1
Test Method: ASTM A884-14: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Epoxy Coating Thickness)
Verified Date: 05/04/2017
Date Tested: 05/02/2017
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: complies
Additional Comments When Verified:
First Bar Mean 11.56 mils
Second Bar Mean 9.61 mils
Lower spec. limit LSL 7 mils
Upper spec. limit USL 40 mils
Total mean value 10.58 mils
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: 2017-04-27-4-2
Test Method: ASTM A884-13: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Holiday)
Verified Date: 05/04/2017
Date Tested: 05/02/2017
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: complies
Additional Comments When Verified:
Total Number of Holiday 0
Total Length 1.7 ft
Holidays Per Linear Foot of Bar 0 holiday per ft
Holiday Test Pass/Fail Pass