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Sample Record for 2019-03-11-3

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

Project Information

Project ID: 210837 DEA: 080J0804 EFIS: 0800000283 COOP: 081625 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-15-34.7/51.6
Work Description: (Alternative Delivery) DESIGN-BUILD OF THE INTERSTATE 15 EXPRESS LANES PROJECT
Location Description: Riverside County and SBD-15-0.0/1.3
Contractor Name: Skanska-Ames, Joint Venture
Contractor Address: 1801 California Avenue, Corona, CA 92881
Resident Engineer: Roy Fisher (reports) Structure Rep.: Roy Fisher

Sample Information

DIME Sample ID: 2019-03-11-3
TL Number from the TL Form:
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: 03/11/2019
Date that the sample was received by the laboratory/organization performing the testing: 03/19/2019
The quantity of what the sample constitutes: 1 lot
A brief description of the sample: Epoxy Coated Dowel
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: JC Supply and Manufacturing

Material Information

Dowel Metal Heat Number: SE18101988, 1202005040, 1201008153, 1202008018, 1202006692, 1201006754 1201009492, 1202009370 1202006692
Dowel Epoxy Batch Number: 8996028085 8V96028644
Dowel Coating Specification: ASTM A775
Dowel Size: 1.25 in
Dowel Coating Color: Green
Dowel Manufacturer:
Dowel Coater: JC Supply And Manufacturing
Release Number:
Quality Assurance Code:
Rebar Size (#):
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2019-03-11-3-1
Test Method: ASTM A884-14: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Epoxy Coating Thickness)
Verified Date: 03/20/2019
Date Tested: 03/20/2019
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 11.68 mils
Second Bar Mean 12.33 mils
Lower spec. limit LSL 7 mils
Upper spec. limit USL 40 mils
Total mean value 12 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: 2019-03-11-3-2
Test Method: ASTM A884-13: Standard Specification for Epoxy-Coated Steel Wire and Welded Wire Reinforcement (Holiday)
Verified Date: 03/20/2019
Date Tested: 03/20/2019
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 1.5
Holidays Per Linear Foot of Bar 0
Holiday Test Pass/Fail Pass