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Sample Record for 2021-05-27-15

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

Project Information

Project ID: 215522 DEA: 112N0994 EFIS: 1121000028 QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-8-R32.0/R44.0
Work Description: REPLACE INDIVIDUAL SLABS AND JOINT SEAL, COLD PLANE AND PAVE WITH HMA.
Location Description: SAN DIEGO COUNTY NEAR ALPINE FROM 0.2 MILE EAST OF VIEJAS CREEK BRIDGE TO 0.9 MILE WEST OF SUNRISE HIGHWAY OVERCROSSING
Contractor Name: RV Concrete
Contractor Address: 605 E Commercial Street, Anaheim, CA 92801
Resident Engineer: David Timms Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-05-27-15
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Quality Assurance
Type of Material: SMTL TM7 - Epoxy Coated Dowels
Sample Taken Date: 05/27/2021
Date that the sample was received by the laboratory/organization performing the testing: 06/02/2021
The quantity of what the sample constitutes: 120 dowel baskets
A brief description of the sample: Fully Coated Dowel Baskets
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Simplex

Material Information

Dowel Metal Heat Number: 295520
Dowel Epoxy Batch Number: 9CH2050060
Dowel Coating Specification: ASTM A775
Dowel Size: 1.25 in
Dowel Coating Color: Green
Dowel Manufacturer: Simplex
Dowel Coater: Simplex
Release Number:
Quality Assurance Code:
Rebar Size (#):

Test Results

Test 1 of 2

DIME Test ID: 2021-05-27-15-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 06/03/2021
Date Tested: 06/02/2021
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 14 mils
Second Bar Mean 13.8 mils
Lower spec. limit LSL 7 mils
Upper spec. limit USL 40 mils
Bar # for First Bar 1
Bar # for Second Bar 2
Total mean value 13.9 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: 2021-05-27-15-2
Test Method: ASTM A884-13: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Holiday)
Verified Date: 06/03/2021
Date Tested: 06/02/2021
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 ft
Holidays Per Linear Foot of Bar 0 holiday per ft
Holiday Test Pass/Fail Pass