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Sample Record for 2026-06-16-24

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

Project Information

Project ID: 1000611 DEA: 120R32U4 EFIS: 1222000054 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-55-0.2/R17.8
Work Description: COLD PLANE, PLACE RHMA, REPLACE CB, SIGNS AND MODIFY LIGHTING SYSTEM.
Location Description: ORANGE COUNTY FROM 0.1 MILE SOUTH OF ROUTE 55/1 SEPARATION IN NEWPORT BEACH TO ROUTE 55/91 SEPARATION IN ANAHEIM
Contractor Name: R.J. NOBLE COMPANY
Contractor Address: 15505 East Lincoln Avenue, Orange, CA 92865
Resident Engineer: Tyrone Taylor Structure Rep.: Matthew Chang

Sample Information

DIME Sample ID: 2026-06-16-24
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Vallejo Field Laboratory
Sample Organization Contact: 9166394315
Type of Sample: Stock
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 06/16/2026
Date that the sample was received by the laboratory/organization performing the testing: 06/26/2026
The quantity of what the sample constitutes: 4000
A brief description of the sample: F959 DTI Washers
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: UIS

Material Information

Rocap Number(s): N/A
Heat Number(s): 141313
Nut Mfg. Lot Number(s): xxx
Washer Mfg. Lot Number(s): 49809
Bolt Specification: xxx
Bolt Length(s): xxx
Nut Specification: xxx
Washer Specification: F959
Finish: HDG
Diameter/Size: 3/4"
Bolt Mfg. Lot Number: xxx
Rocap Test Requirement(s): xxx
Lubricant Requirements(s): xxx
Washer Inner Diameter(s): xxx

Test Results

Test

DIME Test ID: 2026-06-16-24-1
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: 07/09/2026
Date Tested: 07/09/2026
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) no data
Mfg. Lot Number 49809
Finish Coating ASTM B695 - Mech Galv
Product Markings no data
Size 0.75 in
Bolt Length no data in
Measurement Average 3 mils

Test

DIME Test ID: 2026-06-16-24-2
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: 07/09/2026
Date Tested: 07/09/2026
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) no data
Mfg. Lot Number 49809
Finish Coating ASTM B695 - Mech Galv
Product Markings no data
Size 0.75 in
Bolt Length no data in
Measurement Average 3.2 mils

Test

DIME Test ID: 2026-06-16-24-3
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: 07/09/2026
Date Tested: 07/09/2026
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) no data
Mfg. Lot Number 49809
Finish Coating ASTM B695 - Mech Galv
Product Markings no data
Size 0.75 in
Bolt Length no data in
Measurement Average 3.5 mils

Test

DIME Test ID: 2026-06-16-24-4
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: 07/09/2026
Date Tested: 07/09/2026
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. 1D
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 49809
Finish Coating ASTM B695 - Mech Galv
Product Markings no data
Size 0.75 in
Bolt Length no data in
Measurement Average 3.2 mils