Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214836 DEA: 030G9804 EFIS: 0317000313
QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-80-46.3/53.4
Work Description: CONCRETE SLAB REPLACEMENT.
Location Description: PLACER COUNTY FR0M CRYSTAL SPRINGS ROAD OVERCROSSING TO BLUE CANYON ROAD UNDERCROSSING
Contractor Name: FBD VANGUARD CONSTRUCTION, INC.
Contractor Address: 550 Greenville Road, Livermore, CA 94550
Resident Engineer: Tad Sampson Structure Rep.: Unknown
DIME Sample ID: 2020-08-06-4
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 227-7263
Type of Sample: Acceptance
Type of Material: SMTL TM7 - Epoxy Coated Dowels
Sample Taken Date: 08/06/2020
Date that the sample was received by the laboratory/organization performing the testing: 08/11/2020
The quantity of what the sample constitutes: 4490 lbs
A brief description of the sample: 1.5 inch dowels purple
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Simplex - Fernley, NV
Dowel Metal Heat Number: 201168
Dowel Epoxy Batch Number: 3CH2010022
Dowel Coating Specification: ASTM A934
Dowel Size: 1.5 in
Dowel Coating Color: Purple
Dowel Manufacturer: Simplex
Dowel Coater: Simplex
Release Number: 107393-1
Quality Assurance Code:
Rebar Size (#):
DIME Test ID: 2020-08-06-4-1
Test Method: ASTM A934-13: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Epoxy-Coating)
Verified Date: 08/13/2020
Date Tested: 08/12/2020
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: 916-227-7257
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Lower spec. limit LSL
|
7 mils
|
Upper spec. limit USL
|
12 mils
|
Bar # for First Bar
|
1
|
Bar # for Second Bar
|
1
|
First Bar Mean
|
12.4
|
Second Bar Mean
|
11.54
|
Total mean value
|
11.97
|
DIME Test ID: 2020-08-06-4-2
Test Method: ASTM A934-13: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Holiday Bend)
Verified Date: 08/13/2020
Date Tested: 08/12/2020
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: 916-227-7257
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Total Number of Holiday
|
0
|
Total Length
|
1.6
|
Holidays Per Linear Foot of Bar
|
0
|
Holiday Test Pass/Fail
|
Pass
|
Bend Test Pass/Fail
|
NA
|