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Sample Record for 2017-05-19-1

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

Project Information

Project ID: 210914 DEA: 07306204 EFIS: 0714000151 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-91-R11.3/R20.7
Work Description: ROADWAY REHABILITATION
Location Description: IN LOS ANGELES COUNTY, BETWEEN I-710 IN LONG BEACH AND 183RDSTREET IN CERRITOS
Contractor Name: USS CAL BUILDERS
Contractor Address: 8051 Main Street, Stanton, CA 90680
Resident Engineer: Kelvin Tran Structure Rep.: Nabil Shmara

Sample Information

DIME Sample ID: 2017-05-19-1
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT QASI - Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7263
Type of Sample: Quality Assurance
Type of Material: SMTL TM7 - Epoxy Coated Dowels
Sample Taken Date: 05/19/2017
Date that the sample was received by the laboratory/organization performing the testing: 05/22/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: Epoxy Coated Dowel Basket
From where was the sample collected: Source
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Dayton Superior Modesto

Material Information

Dowel Metal Heat Number: 17102445
Dowel Epoxy Batch Number: 7396024285
Dowel Coating Specification: ASTM A775
Dowel Size: 1.5 in
Dowel Coating Color: Green
Dowel Manufacturer: Dayton Superior
Dowel Coater: Dayton Superior
Release Number: 1320744-1
Quality Assurance Code: Unknown
Rebar Size (#):

Test Results

Test 1 of 2

DIME Test ID: 2017-05-19-1-2
Test Method: ASTM A884-13: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Holiday)
Verified Date: 05/24/2017
Date Tested: 05/23/2017
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: paul.lukkarila@dot.ca.gov
Organization Phone: (916) 227-7253
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Total Number of Holiday 0
Total Length 3 ft
Holidays Per Linear Foot of Bar 0 holiday per ft
Holiday Test Pass/Fail Pass

Test 2 of 2

DIME Test ID: 2017-05-19-1-3
Test Method: ASTM A884-14: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Epoxy Coating Thickness)
Verified Date: 05/24/2017
Date Tested: 05/23/2017
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: paul.lukkarila@dot.ca.gov
Organization Phone: (916) 227-7253
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
First Bar Mean 10.74 mils
Second Bar Mean 11.04 mils
Lower spec. limit LSL 7
Upper spec. limit USL 40
Total mean value 10.89 mils
Total number of values less than LSL no data
Total number of values greater than USL no data

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.