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Sample Record for 2025-01-28-3

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

Project Information

Project ID: 994654 DEA: 07313504 EFIS: 0715000090 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,VEN-1-37.7/62.9,0.0/0.9
Work Description: REMOVE AND CONSTRUCT BRIDGE AND CULVERTS.
Location Description: LOS ANGELES AND VENTURA COUNTIES AT VARIOUS LOCATIONS FROM 0.4 MILE SOUTH OF TEMESCAL CANYON ROAD TO 0.1 MILE NORTH OF TONGA STREET
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 13170 TELFAIR AVENUE, SYLMAR, CA 91342
Resident Engineer: Dan Leon Structure Rep.: Aziz Maghsoudloo

Sample Information

DIME Sample ID: 2025-01-28-3
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 01/28/2025
Date that the sample was received by the laboratory/organization performing the testing: 02/03/2025
The quantity of what the sample constitutes: 1115
A brief description of the sample: F436 Flat Washer
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Universal Industrial Sales, Inc.

Material Information

Rocap Number(s): na
Heat Number(s): 228552
Nut Mfg. Lot Number(s): na
Washer Mfg. Lot Number(s): 228552 / 31284
Bolt Specification: na
Bolt Length(s): na
Nut Specification: na
Washer Specification: F436
Finish: HDG
Diameter/Size: 5/8"
Bolt Mfg. Lot Number: na
Rocap Test Requirement(s): na
Lubricant Requirements(s): na
Washer Inner Diameter(s):
Test results on following page(s): 6

Test Results

Test 1 of 6

DIME Test ID: 2025-01-28-3-1
Test Method: ASTM B499-09r21: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 02/18/2025
Date Tested: 02/14/2025
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: Atlas Technical Consultants
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) 228552
Mfg. Lot Number no data
Finish Coating Plain
Product Markings no data
Size 0.625 in
Bolt Length no data in
Measurement Average 2.6 mils

Test 2 of 6

DIME Test ID: 2025-01-28-3-2
Test Method: ASTM B499-09r21: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 02/18/2025
Date Tested: 02/14/2025
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: Atlas Technical Consultants
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1B
Rocap Number no data
Heat Number(s) 228552
Mfg. Lot Number no data
Finish Coating Plain
Product Markings no data
Size 0.625 in
Bolt Length no data in
Measurement Average 3.5 mils

Test 3 of 6

DIME Test ID: 2025-01-28-3-3
Test Method: ASTM B499-09r21: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 02/18/2025
Date Tested: 02/14/2025
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: Atlas Technical Consultants
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1C
Rocap Number no data
Heat Number(s) 228552
Mfg. Lot Number no data
Finish Coating Plain
Product Markings no data
Size 0.625 in
Bolt Length no data in
Measurement Average 2.7 mils

Test 4 of 6

DIME Test ID: 2025-01-28-3-4
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 02/18/2025
Date Tested: 02/14/2025
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: Atlas Technical Consultants
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) 228552
Mfg. Lot Number no data
Finish Coating Plain
Product Markings no data
Size 0.625 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 38.7
Spacing Ok

Test 5 of 6

DIME Test ID: 2025-01-28-3-5
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 02/18/2025
Date Tested: 02/14/2025
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: Atlas Technical Consultants
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1B
Rocap Number no data
Heat Number(s) 228552
Mfg. Lot Number no data
Finish Coating Plain
Product Markings no data
Size 0.625 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 39
Spacing Ok

Test 6 of 6

DIME Test ID: 2025-01-28-3-6
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 02/18/2025
Date Tested: 02/14/2025
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: Atlas Technical Consultants
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1C
Rocap Number no data
Heat Number(s) 228552
Mfg. Lot Number no data
Finish Coating Plain
Product Markings no data
Size 0.625 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 38.6
Spacing Ok