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Sample Record for 2016-10-28-4

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

Project Information

Project ID: 8196 DEA: 59912684 QA Service Level: 1
DIST-CO-RTE-PM: 59---
Work Description:
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2016-10-28-4
TL Number from the TL Form: C875577
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: 10/28/2016
Date that the sample was received by the laboratory/organization performing the testing: 11/02/2016
The quantity of what the sample constitutes: 2
A brief description of the sample: Green Epoxy Dowels
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Dayton Superior

Material Information

Dowel Metal Heat Number: SE16103106
Dowel Epoxy Batch Number: Unknown
Dowel Coating Specification: ASTM A775
Dowel Size: 1.5 in
Dowel Coating Color: Green
Dowel Manufacturer: Unknown
Dowel Coater: Dayton Superior
Release Number: 10-28-16-1-1
Quality Assurance Code: Unknown
Rebar Size (#):
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2016-10-28-4-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 11/02/2016
Date Tested: 11/02/2016
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 13.21 mils
Second Bar Mean 13.15 mils
Lower spec. limit LSL 7 mils
Upper spec. limit USL 40 mils
Bar # for First Bar no data
Bar # for Second Bar no data
Total mean value 13.18 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: 2016-10-28-4-2
Test Method: ASTM A884-13: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Holiday)
Verified Date: 11/02/2016
Date Tested: 11/02/2016
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