Sample Record for 2026-04-15-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 995228 DEA: 07347904 EFIS: 0718000123
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-405-31.2/41.4
Work Description: COLD PLANE, PLACE HMA, RHMA, JPCP, ISR, & REPLACE BRIDGE SLABS.
Location Description: LOS ANGELES FROM WILSHIRE BOULEVARD UNDERCROSSING TO VICTORY BOULEVARD UNDERCROSSING
Contractor Name: RASMUSSEN/VANGUARD
Contractor Address: 28548 Livingston Ave, Valencia , CA,91355-4171
Resident Engineer: Ridwan Salman Structure Rep.: Gon Choi
Sample Information
DIME Sample ID: 2026-04-15-2
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: 04/15/2026
Date that the sample was received by the laboratory/organization performing the testing: 09/04/2026
The quantity of what the sample constitutes: 3 of 1438
A brief description of the sample: 3/4" F959 DTI MG
From where was the sample collected: Supplier
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: UIS Lindon UT
Material Information
Rocap Number(s): None
Heat Number(s): 241423
Nut Mfg. Lot Number(s): N/A
Washer Mfg. Lot Number(s): ABTBY
Bolt Specification: N/A
Bolt Length(s): N/A
Nut Specification: N/A
Washer Specification: ASTM F959
Finish: galvanize
Diameter/Size: 3/4
Bolt Mfg. Lot Number: N/A
Rocap Test Requirement(s): NONE
Lubricant Requirements(s): NONE
Washer Inner Diameter(s): None
Bolt Mill Supplier:
Nut Mill Supplier:
Washer Mill Supplier:
Test Results
Test
DIME Test ID: 2026-04-15-2-1
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: 09/22/2026
Date Tested: 09/17/2026
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: brian.ellis@dot.ca.gov
Organization Phone: (916) 380-8623
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
|
Sample No.
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1A
|
|
Rocap Number
|
no data
|
|
Heat Number(s)
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241423
|
|
Mfg. Lot Number
|
no data
|
|
Finish Coating
|
ASTM B695 - Mech Galv
|
|
Product Markings
|
no data
|
|
Size
|
0.75 in
|
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Bolt Length
|
no data in
|
|
Measurement Average
|
5.1 mils
|
Test
DIME Test ID: 2026-04-15-2-2
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: 09/22/2026
Date Tested: 09/17/2026
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: brian.ellis@dot.ca.gov
Organization Phone: (916) 380-8623
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
|
Sample No.
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1B
|
|
Rocap Number
|
no data
|
|
Heat Number(s)
|
241423
|
|
Mfg. Lot Number
|
no data
|
|
Finish Coating
|
ASTM B695 - Mech Galv
|
|
Product Markings
|
no data
|
|
Size
|
0.75 in
|
|
Bolt Length
|
no data in
|
|
Measurement Average
|
4 mils
|
Test
DIME Test ID: 2026-04-15-2-3
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: 09/22/2026
Date Tested: 09/17/2026
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: brian.ellis@dot.ca.gov
Organization Phone: (916) 380-8623
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
|
Sample No.
|
1C
|
|
Rocap Number
|
no data
|
|
Heat Number(s)
|
241423
|
|
Mfg. Lot Number
|
no data
|
|
Finish Coating
|
ASTM B695 - Mech Galv
|
|
Product Markings
|
no data
|
|
Size
|
0.75 in
|
|
Bolt Length
|
no data in
|
|
Measurement Average
|
4.1 mils
|
