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Sample Record for 2016-10-24-2

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

Project Information

Project ID: 208944 DEA: 07187224 EFIS: 0700000189 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-126-R6.8/R9.2
Work Description: SR 126/Commerce Center Drive Interchange Project
Location Description: Northwest of the City of Santa Clarita in unincorporated Los Angeles County
Contractor Name: C.A. Rasmussen, Inc.
Contractor Address: 28548 Livingston Avenue, Valencia, CA 91355-4171
Resident Engineer: Daniel Widjaja Structure Rep.: Sarah Hartz

Sample Information

DIME Sample ID: 2016-10-24-2
TL Number from the TL Form: C927503
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: 10/24/2016
Date that the sample was received by the laboratory/organization performing the testing: 10/25/2016
The quantity of what the sample constitutes: 2
A brief description of the sample: Epoxy Coated Dowel
From where was the sample collected: Source
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Dayton

Material Information

Dowel Metal Heat Number: SE16103106
Dowel Epoxy Batch Number: Unknown
Dowel Coating Specification: ASTM A934
Dowel Size: 1.5 in
Dowel Coating Color: Purple
Dowel Manufacturer: Dayton Superior
Dowel Coater: Dayton Superior
Release Number: 1270712-2
Quality Assurance Code: Unknown
Rebar Size (#):
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2016-10-24-2-1
Test Method: ASTM A884-14: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Epoxy Coating Thickness)
Verified Date: 10/27/2016
Date Tested: 10/26/2016
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 13.07 mils
Second Bar Mean 10.58 mils
Lower spec. limit LSL 7 mils
Upper spec. limit USL 40 mils
Total mean value 11.82 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: 2016-10-24-2-2
Test Method: ASTM A884-13: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Holiday)
Verified Date: 10/27/2016
Date Tested: 10/26/2016
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 3 ft
Holidays Per Linear Foot of Bar 0 holiday per ft
Holiday Test Pass/Fail Pass