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Sample Record for 2017-07-28-6

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

Project Information

Project ID: 209732 DEA: 072881U4 EFIS: 0714000085 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-210-R16.1/R25.8
Work Description: CONSTRUCT CONCRETE PAVEMENT, PRECAST CONCRETE PANELS, AND SLABS.
Location Description: LOS ANGELES COUNTY IN LA CANADA FLINTRIDGE, GLENDALE AND PASADENA FROM DUNSMORE AVENUE UNDERCROSSING TO NORTH LOS ROBLES AVENUE OVERCROSSING
Contractor Name: FLATIRON WEST, INC.
Contractor Address: 1770 LA COSTA MEADOWS DRIVE, SAN MARCOS, CA 92078
Resident Engineer: Sushil Chaudhari Structure Rep.: Mark Amorsolo

Sample Information

DIME Sample ID: 2017-07-28-6
TL Number from the TL Form: C970787
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM7 - Epoxy Coated Dowels
Sample Taken Date: 07/28/2017
Date that the sample was received by the laboratory/organization performing the testing: 08/01/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: Epoxy Coated Dowel Bar
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: JC Supply Manufacturing

Material Information

Dowel Metal Heat Number: PL17102418
Dowel Epoxy Batch Number: 7596024672
Dowel Coating Specification: ASTM A775
Dowel Size: 1.25 in
Dowel Coating Color: Green
Dowel Manufacturer: JC Supply And Manufacturing
Dowel Coater: JC Supply And Manufacturing
Release Number: Unknown
Quality Assurance Code: Unknown
Rebar Size (#):
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2017-07-28-6-1
Test Method: ASTM A775-07b-re14: Standard Specification for Epoxy-Coated Steel Reinforcing Bars (Epoxy Coating)
Verified Date: 08/02/2017
Date Tested: 08/01/2017
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 8.54 mils
Second Bar Mean 8.24 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 8.39 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: 2017-07-28-6-2
Test Method: ASTM A934-13: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Holiday Bend)
Verified Date: 08/02/2017
Date Tested: 08/01/2017
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 30 ft
Holidays Per Linear Foot of Bar 0 holiday pe
Holiday Test Pass/Fail Pass
Bend Test Pass/Fail NA