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Sample Record for 2025-09-24-8

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

Project Information

Project ID: 994828 DEA: 043Y4104 EFIS: 0423000232 QA Service Level: 1
DIST-CO-RTE-PM: 04-CC,SM-680-25.04/25.46, VAR/VAR
Work Description: Paint removal and non-destructive testing (NDT) on butt weld connections on T1 type steel in fracture critical members of three distinct existing toll bridge.
Location Description: Carquinez Bridge Overhead (Br. No. 23-0015R), Benicia-Martinez Bridge Overhead (Br. No. 28-0153L), and San Mateo-Hayward Bridge (Br. No. 35-0054). County = SM,CC,SOL. Route = 680,80,92.
Contractor Name: Golden State Bridge Inc.
Contractor Address: Unknown
Resident Engineer: Kingston Atako Structure Rep.: Angelo Perez

Sample Information

DIME Sample ID: 2025-09-24-8
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: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 09/24/2025
Date that the sample was received by the laboratory/organization performing the testing: 09/24/2025
The quantity of what the sample constitutes: 30
A brief description of the sample: 7/8 - 9 4-3/4" ASTM F3125 GR A490 Bolt
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Bay Bolt

Material Information

Rocap Number(s): 3511-09
Heat Number(s): Bolt 810115 Nut W000245738 Washer 42329370
Nut Mfg. Lot Number(s): W000245738
Washer Mfg. Lot Number(s): 181439
Bolt Specification: ASTM F3125 GR A490
Bolt Length(s): 4.75"
Nut Specification: ASTM A194
Washer Specification: ASTM F436
Finish: Plain
Diameter/Size: 7/8 - 9
Bolt Mfg. Lot Number: 135670A
Rocap Test Requirement(s):
Lubricant Requirements(s):
Washer Inner Diameter(s):
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2025-09-24-8-3
Test Method: ASME B1.2-83r17: (Pitch Diameter) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Pitch Diameter)
Verified Date: 10/02/2025
Date Tested: 09/25/2025
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) no data
Mfg. Lot Number 135670A
Finish Coating Plain
Product Markings A490 N
Size 0.875 in
Bolt Length 4.75 in
Pitch Diameter 0.792 in
Pitch Diameter 2nd 0.792 in