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Testing Report for 2017-07-28-6-2

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

Project Information

DEA: 072881U4
EFIS: 0714000085
Project ID: 209732
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: Unknown
Contractor Address: Unknown
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 QASI - Los Angeles Field Laboratory
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM7 - Epoxy Coated Dowels
Sample Taken Date: 7/28/2017
Date that the sample was received by the laboratory/organization performing the testing: 8/1/2017
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 Information

DIME Test ID: 2017-07-28-6-2
Test Method: ASTM A934-13: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Holiday Bend)
Date Tested: 8/1/2017
Verified Date: 8/2/2017
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: paul.lukkarila@dot.ca.gov
Organization Phone: (916) 227-7253
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Total Number of Holiday: no data
Total Length: 30 ft
Holidays Per Linear Foot of Bar: no data
Holiday Test Pass/Fail: Pass
Bend Test Pass/Fail: NA