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Sample Record for 2025-05-05-8

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

Project Information

Project ID: 994358 DEA: 033J3304 EFIS: 0322000251 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-12-0/0.5
Work Description: MMBN Project. Replace backup drive system, replace lift span deck, install hydraulic barrier system and new generator, replace electrical control system, install new traffic gates and elevators, traffic control,
Location Description:
Contractor Name: Golden State Bridge, Inc.
Contractor Address: 3701 Mallard Drive, Benicia, CA 94510
Resident Engineer: Ephrem Tweldeberham Structure Rep.: Rusty D'Anna

Sample Information

DIME Sample ID: 2025-05-05-8
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: Acceptance
Type of Material: SMTL TM6 - Steel Check Sample Plate
Sample Taken Date: 05/05/2025
Date that the sample was received by the laboratory/organization performing the testing: 05/05/2025
The quantity of what the sample constitutes: 3/4 inch plate
A brief description of the sample: A709 Steel Check Sample
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name: Rio Vista Bridge
The fabricator/manufacturer/facility name: XKT Engineering

Material Information

Heat Number(s): W2F562
Material Specification: A709
Grade: 50W-A/B
Thickness: .75
Shape: Square
Metal Foundry Manufacturer (Mill): SSAB Alabama
Plate Dimension: 60" x 72"
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2025-05-05-8-1
Test Method: ASTM E23-18: Standard Test Methods for Notched Bar Impact Testing of Metallic Materials (Charpy Impact)
Verified Date: 07/08/2025
Date Tested: 07/08/2025
Submitted By Organization: Atlas - Oakland
Organization Address: 534 23rd Avenue,
Organization City: Oakland
Organization State: CA
Organization Zipcode: 94606
Organization Email: guillermo.baltazar@oneatlas.com
Organization Phone: (510) 434-3018
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Temperature Required 40 oF
Minimum Energy Required 25 ftlb
Test Temperature 1 40 oF
Impact Energy 1 258 ftlb
Impact Energy 2 258 ftlb
Impact Energy 3 258 ftlb
Average Impact Energy 258 ftlb
Striker Radius 10 mm
Value Exceeds The Machine Capacity? No

Test 2 of 3

DIME Test ID: 2025-05-05-8-2
Test Method: ASTM A370-20: Standard Test Methods and Definitions for Mechanical Testing of Steel Products (Tensile - Round Sample)
Verified Date: 07/08/2025
Date Tested: 06/20/2025
Submitted By Organization: Atlas - Oakland
Organization Address: 534 23rd Avenue,
Organization City: Oakland
Organization State: CA
Organization Zipcode: 94606
Organization Email: guillermo.baltazar@oneatlas.com
Organization Phone: (510) 434-3018
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleHeat NumberDiameter (in)Area (sqin)Stress at Offset (psi)Tensile Strength (psi)Elongation in 4 x d (%)Tested By
1AW2F5620.5040.1995668008020032W Torres
UTM NA
Temperature 72 f

Test 3 of 3

DIME Test ID: 2025-05-05-8-3
Test Method: ASTM E415-21: Standard Test Method for Analysis of Carbon and Low-Alloy Steel by Spark Atomic Emission Spectrometry
Verified Date: 07/08/2025
Date Tested: 07/08/2025
Submitted By Organization: Atlas - Oakland
Organization Address: 534 23rd Avenue,
Organization City: Oakland
Organization State: CA
Organization Zipcode: 94606
Organization Email: guillermo.baltazar@oneatlas.com
Organization Phone: (510) 434-3018
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Content, carbon 0.06 %
Content, Si 0.33 %
Content, Mn 1.10 %
Content, P 0.013 %
Content, S 0.005 %
Content, Cr 0.51 %
Content, Mo no data %
Content, Al no data %
Content, Co no data %
Content, Copper 0.28 %
Content, Nb no data %
Content, Ti 0.01 %
Content, V 0.07 %
Content, Lead no data %
Content, Boron no data %
Content, Fe no data %
Content, Ni 0.32 %