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Sample Record for 2025-04-11-3

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

Project Information

Project ID: 1000580 DEA: 071XW104 EFIS: 0723000028 QA Service Level: 1
DIST-CO-RTE-PM: 07---
Work Description: VENTURA COUNTY IN CITY OF FILLMORE VEN-126REPLACE/CONSTRUCT THE FILLMORE MAINTENANCESTATION DAMAGED BY HIGH WINDS DIR\\'S EMERGENCY
Location Description:
Contractor Name: MGP CONSTRUCTION DBA MICHAEL
Contractor Address: PO BOX 355, UPLAND, CA 91785
Resident Engineer: ALFRED IRA Structure Rep.: Heidi Bernstein

Sample Information

DIME Sample ID: 2025-04-11-3
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 TM3 - Fastener Assembly
Sample Taken Date: 04/11/2025
Date that the sample was received by the laboratory/organization performing the testing: 04/17/2025
The quantity of what the sample constitutes: 2 of 48
A brief description of the sample: F1554 Grade 55 HDG Anchor Bolts
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue Circle Corp

Material Information

Rocap Number(s): N/A
Heat Number(s): 1201061488
Nut Mfg. Lot Number(s): N/A
Washer Mfg. Lot Number(s): N/A
Bolt Specification: F1554
Bolt Length(s): 18" - 38"
Nut Specification: N/A
Washer Specification: N/A
Finish: ASTM F2329
Diameter/Size: 3/4
Bolt Mfg. Lot Number: 18 inch lot 99285-1 ; 36 inch lot 99285-2
Rocap Test Requirement(s):
Lubricant Requirements(s):
Washer Inner Diameter(s):
Test results on following page(s): 6

Test Results

Test 1 of 6

DIME Test ID: 2025-04-11-3-1
Test Method: ASME B1.2-83r17: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Verified Date: 05/08/2025
Date Tested: 04/18/2025
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:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) 1201061488
Mfg. Lot Number no data
Finish Coating ASTM F2329 - Hot Dip
Product Markings YELLOW
Size 0.75 in
Bolt Length 18 in
Gage Type Pass

Test 2 of 6

DIME Test ID: 2025-04-11-3-2
Test Method: ASME B1.2-83r17: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Verified Date: 05/08/2025
Date Tested: 04/18/2025
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:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 2A
Rocap Number no data
Heat Number(s) 1201061488
Mfg. Lot Number no data
Finish Coating ASTM F2329 - Hot Dip
Product Markings YELLOW
Size 0.75 in
Bolt Length 38 in
Gage Type Pass

Test 3 of 6

DIME Test ID: 2025-04-11-3-3
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: 05/08/2025
Date Tested: 05/08/2025
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: Tested by Kleinfelder Lab
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number no data
Finish Coating ASTM F2329 - Hot Dip
Product Markings 0
Size 0.75 in
Bolt Length 18 in
Measurement Average 4.8 mils

Test 4 of 6

DIME Test ID: 2025-04-11-3-4
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: 05/08/2025
Date Tested: 05/08/2025
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: Tested by Kleinfelder Lab
Test Result Compliance:
Additional Comments When Verified:
Sample No. 2a
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number no data
Finish Coating ASTM F2329 - Hot Dip
Product Markings 0
Size 0.75
Bolt Length 38
Measurement Average 4.9

Test 5 of 6

DIME Test ID: 2025-04-11-3-5
Test Method: ASTM F606-21: Standard Test Methods for Determining the Mechanical Properties of Externally and Internally Threaded Fasteners, Washers, Direct Tension Indicators, and Rivets (Hex Cap Screws)
Verified Date: 05/08/2025
Date Tested: 05/08/2025
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: Tested by Kleinfelder Lab
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleSizeArea (in^2)Peak Load (lbf)Peak Load (kN)Tensile Strength (psi)Stress at Offset (psi)Load at Offset (lbf)Comments
10.75 x38"0.33429070129870366461121580lot 99285-2
UTM NA
Temperature 72

Test 6 of 6

DIME Test ID: 2025-04-11-3-6
Test Method: ASTM F606-21: Standard Test Methods for Determining the Mechanical Properties of Externally and Internally Threaded Fasteners, Washers, Direct Tension Indicators, and Rivets (Tensile, Yield and Elongation)
Verified Date: 05/08/2025
Date Tested: 05/08/2025
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: Test by Kleinfelder Lab
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
Heat NumberDiameter (in)Area (sqin)Stress at Offset (psi)Tensile Strength (psi)Elongation in 4 x d (%)Tested By
1201061488 99285-10.50.196704369009529M Kalwasinski Kleinfelder Lab
UTM NA
Temperature 72 f