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Sample Record for 2016-12-23-1

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

Project Information

Project ID: 211808 DEA: 11429104 EFIS: 1117000047 QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-15-8.67
Work Description: 60 inch Diameter CMP Culvert
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2016-12-23-1
TL Number from the TL Form: NA
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: 12/23/2016
Date that the sample was received by the laboratory/organization performing the testing: 12/23/2016
The quantity of what the sample constitutes: 2
A brief description of the sample: Green Epoxy Dowels
From where was the sample collected: Job Site
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: JC Supply Manufacturing

Material Information

Dowel Metal Heat Number: NA
Dowel Epoxy Batch Number: NA
Dowel Coating Specification: ASTM A884
Dowel Size: 1.5 in
Dowel Coating Color: Green
Dowel Manufacturer: Unknown
Dowel Coater: JC Supply And Manufacturing
Release Number: Unknown
Quality Assurance Code: NA
Rebar Size (#):
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2016-12-23-1-1
Test Method: ASTM A884-14: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Epoxy Coating Thickness)
Verified Date: 12/27/2016
Date Tested: 12/27/2016
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 9.32 mils
Second Bar Mean 9.84 mils
Lower spec. limit LSL 7 mils
Upper spec. limit USL 40 mils
Total mean value 9.58 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: 2016-12-23-1-2
Test Method: ASTM A884-13: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Holiday)
Verified Date: 12/27/2016
Date Tested: 12/27/2016
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 no data0
Total Length 3 ft
Holidays Per Linear Foot of Bar no data0 holiday per ft
Holiday Test Pass/Fail Pass