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Sample Record for 2017-10-24-1

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

Project Information

Project ID: 212566 DEA: 120Q8604 EFIS: 1217000117 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-57-11.0/19.6
Work Description: SLAB REPLACEMENT (RSC), GRIND & GROOVE CONC PVMT, RHMA-G PVMT
Location Description: ORANGE COUNTY IN ORANGE, ANAHEIM, PLACENTIA, AND FULLERTON FROM 0.2 MILE SOUTH OF CHAPMAN AVENUE UNDERCROSSING TO ASSOCIATED ROAD UNDERCROSSING
Contractor Name: AUTOBAHN CONSTRUCTION INC.
Contractor Address: 933 N. Batavia Street, Orange, CA 92867
Resident Engineer: Adrian Wu Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2017-10-24-1
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Recertification
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 10/24/2017
Date that the sample was received by the laboratory/organization performing the testing: 10/30/2017
The quantity of what the sample constitutes: 30 shipments
A brief description of the sample: Epoxy Coated Dowels
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: J C Supply - Manufacturing

Material Information

Rebar Heat Number(s): Dowel Heat PL 16208488
Rebar Epoxy Batch Number(s):
Rebar Coating Specification: ASTM A775
Rebar Size (#): Dowel 1.5"X 18"
Rebar Coating Color: Green
Rebar Manufacturer: Dowel,Nucor
Rebar Coater: JC Supply And Manufacturing
Rebar Powder Manufacturer: Valspar
Release Number: Unknown
Quality Assurance Code: Unknown

Test Results

Test 1 of 2

DIME Test ID: 2017-10-24-1-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 10/31/2017
Date Tested: 10/31/2017
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:
Additional Comments When Verified:
First Bar Mean 10.73
Second Bar Mean 9.47
Lower spec. limit LSL 7
Upper spec. limit USL 40
Bar # for First Bar no data
Bar # for Second Bar no data
Total mean value 10.1
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: 2017-10-24-1-2
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Holiday)
Verified Date: 10/31/2017
Date Tested: 10/31/2017
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:
Additional Comments When Verified:
Total Number of Holiday 0
Total Length 3
Holidays Per Linear Foot of Bar 0
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail NA