Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002212 DEA: 033J3104 EFIS: 0322000248
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-12-3.5/3.8
Work Description: Jackson Slough Road Intersection Improvement
Location Description:
Contractor Name: TIM PAXINS PACIFIC EXCAVATION, INC
Contractor Address: 9796 Kent Street, Elk Grove CA 95624
Resident Engineer: Lorraine Tullo Structure Rep.: Nicolas Sanders
DIME Sample ID: 2026-06-12-4
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: 06/12/2026
Date that the sample was received by the laboratory/organization performing the testing: 06/10/2026
The quantity of what the sample constitutes: 3 of 442
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
Rocap Number(s): N/A
Heat Number(s): 1201071738
Nut Mfg. Lot Number(s): N/A
Washer Mfg. Lot Number(s): N/A
Bolt Specification: F1554
Bolt Length(s): 42"
Nut Specification: N/A
Washer Specification: N/A
Finish: Galvanized
Diameter/Size: 2-1/4
Bolt Mfg. Lot Number: 120107173822
Rocap Test Requirement(s): none
Lubricant Requirements(s): none
Washer Inner Diameter(s): none
DIME Test ID: 2026-06-12-4-1
Test Method: ASME B1.2-83r17: (Pitch Diameter) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Pitch Diameter)
Verified Date: 07/21/2026
Date Tested: 06/19/2026
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.
|
1A
|
|
Rocap Number
|
no data
|
|
Heat Number(s)
|
1201071738
|
|
Mfg. Lot Number
|
no data
|
|
Finish Coating
|
ASTM F2329 - Hot Dip
|
|
Product Markings
|
YELLOW
|
|
Size
|
2.25 in
|
|
Bolt Length
|
42 in
|
|
Pitch Diameter
|
2.120 in
|
|
Pitch Diameter 2nd
|
no data in
|
DIME Test ID: 2026-06-12-4-2
Test Method: ASME B1.2-83r17: (Pitch Diameter) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Pitch Diameter)
Verified Date: 07/21/2026
Date Tested: 06/19/2026
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.
|
1B
|
|
Rocap Number
|
no data
|
|
Heat Number(s)
|
1201071738
|
|
Mfg. Lot Number
|
no data
|
|
Finish Coating
|
ASTM F2329 - Hot Dip
|
|
Product Markings
|
YELLOW
|
|
Size
|
2.25 in
|
|
Bolt Length
|
42 in
|
|
Pitch Diameter
|
2.121 in
|
|
Pitch Diameter 2nd
|
no data in
|
DIME Test ID: 2026-06-12-4-3
Test Method: ASME B1.2-83r17: (Pitch Diameter) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Pitch Diameter)
Verified Date: 07/21/2026
Date Tested: 06/19/2026
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)
|
1201071738
|
|
Mfg. Lot Number
|
no data
|
|
Finish Coating
|
ASTM F2329 - Hot Dip
|
|
Product Markings
|
YELLOW
|
|
Size
|
2.25 in
|
|
Bolt Length
|
42 in
|
|
Pitch Diameter
|
2.120 in
|
|
Pitch Diameter 2nd
|
no data in
|
DIME Test ID: 2026-06-12-4-4
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: 07/21/2026
Date Tested: 07/21/2026
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.
|
1A
|
|
Rocap Number
|
no data
|
|
Heat Number(s)
|
1201071738
|
|
Mfg. Lot Number
|
no data
|
|
Finish Coating
|
ASTM F2329 - Hot Dip
|
|
Product Markings
|
no data
|
|
Size
|
2.25 in
|
|
Bolt Length
|
42 in
|
|
Measurement Average
|
6.4 mils
|
DIME Test ID: 2026-06-12-4-5
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: 07/21/2026
Date Tested: 07/21/2026
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.
|
1B
|
|
Rocap Number
|
no data
|
|
Heat Number(s)
|
1201071738
|
|
Mfg. Lot Number
|
no data
|
|
Finish Coating
|
ASTM F2329 - Hot Dip
|
|
Product Markings
|
no data
|
|
Size
|
2.25 in
|
|
Bolt Length
|
42 in
|
|
Measurement Average
|
6.3 mils
|
DIME Test ID: 2026-06-12-4-6
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: 07/21/2026
Date Tested: 07/21/2026
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)
|
1201071738
|
|
Mfg. Lot Number
|
no data
|
|
Finish Coating
|
ASTM F2329 - Hot Dip
|
|
Product Markings
|
no data
|
|
Size
|
2.25 in
|
|
Bolt Length
|
42 in
|
|
Measurement Average
|
6.2 mils
|
DIME Test ID: 2026-06-12-4-7
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 (Proof Load with Wedge)
Verified Date: 07/21/2026
Date Tested: 07/21/2026
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:
|
Number of Bolt Samples
|
2
|
| Sample | Bolt Mfg. Lot Number | Size (in) | Peak Load (lbf) | Peak Load (kN) | Wedge Angle (deg) | Comments | Tested By | | 1A | 1201071738 | 2.25 | 272940 | 0000 | 0 | yield 233000 | Atlas | | 1B | 1201071738 | 2.25 | 271840 | 0000 | 0 | yield 231000 | Atlas |
| |
|
UTM
|
NA
|
|
Temperature
|
0 f
|
