Sample Record
Owner Lab
- CT HQ - Sacramento Structural Materials Testing Laboratory
DIME Sample ID 2021-10-22-4
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Project Information
| Project Identifiers | Project ID: 213750 DEA: 120K0224 EFIS: 1214000097 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-5-14.5/17.1 |
| Award Date | 03/05/2019 |
| Closeout Date | Not set |
| Work Description | South County Improvement Project (Phase 2 - Oso/Alicia) CONST BRIDGES, RW, SW, HMA PVMT, JPCP, DRAINAGE, AND ELECT SYSTEMS. |
| Location Description | ORANGE COUNTY IN MISSION VIEJO AND LAGUNA HILLS FROM 0.7 MILE SOUTH OF OSO PARKWAY OVERCROSSING TO 0.3 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING |
| QA Service Level | 1 (Verified on 04/15/2019) |
Sample Information
| Sample Taken Date | 10/22/2021 | Sample Unique Key | 4 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | Yes | Date that the sample was received by the laboratory/organization performing the testing | 10/26/2021 |
| Sample type | Verification | A brief description of the sample | Epoxy Coated Dowel Basket |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Arthur | Last name of sampler or witnessed by | Peterson |
| Title of sampler | Telephone number of sampler | 7073428602 | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | American Highway - Simplex | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L110-141-21 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM7 - Epoxy Coated Dowels | Dowel Metal Heat Number | 201860 |
|---|---|---|---|
| Dowel Epoxy Batch Number | 3CH2112012 | Dowel Coating Specification | ASTM A775 |
| Dowel Size | 1.5 in | Dowel Coating Color | Green |
| Dowel Manufacturer | American Highway Simplex | Dowel Coater | American Highway Simplex |
| Release Number | Quality Assurance Code | ||
| Rebar Size (#) | #12 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-10-22-4-1 ASTM A775-07b-re14 (Verified)
DIME Test ID: 2021-10-22-4-2 ASTM A775-07b-re14 (Verified)