Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000878 DEA: 07353204 EFIS: 0718000253
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-405-0.0/12.8
Work Description: COLD PLANE AC PAVEMENT, PLACE HMA AND CONCRETE PAVEMENT.
Location Description: LOS ANGELES COUNTY ON ROUTE 405 AND AT VARIOUS LOCATIONS FROM ORANGE COUNTY LINE TO ROUTE 405/110 SEPARATION
Contractor Name: Powell Constructors
Contractor Address: 8555 BANANA AVE, FONTANA, CA 92335
Resident Engineer: Thang Ton Structure Rep.: Anayo Ukwuani
DIME Sample ID: 2026-06-25-2
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: 06/25/2026
Date that the sample was received by the laboratory/organization performing the testing: 09/03/2026
The quantity of what the sample constitutes: 13085
A brief description of the sample: A563 Hex Nut
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Universal Industrial Sales Inc.
Rocap Number(s): na
Heat Number(s): 21051030
Nut Mfg. Lot Number(s): BZZP3
Washer Mfg. Lot Number(s): na
Bolt Specification: na
Bolt Length(s): na
Nut Specification: A563-DH
Washer Specification: na
Finish: HDG
Diameter/Size: 2"
Bolt Mfg. Lot Number: na
Rocap Test Requirement(s): na
Lubricant Requirements(s): na
Washer Inner Diameter(s): na
Bolt Mill Supplier:
Nut Mill Supplier:
Washer Mill Supplier:
DIME Test ID: 2026-06-25-2-1
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: 09/14/2026
Date Tested: 09/08/2026
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
|
BZZP3
|
|
Finish Coating
|
ASTM F2329 - Hot Dip
|
|
Product Markings
|
no data
|
|
Size
|
2 in
|
|
Bolt Length
|
no data in
|
|
Measurement Average
|
7.4 mils
|
DIME Test ID: 2026-06-25-2-2
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: 09/14/2026
Date Tested: 09/08/2026
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
|
BZZP3
|
|
Finish Coating
|
ASTM F2329 - Hot Dip
|
|
Product Markings
|
no data
|
|
Size
|
2 in
|
|
Bolt Length
|
no data in
|
|
Measurement Average
|
7.1 mils
|
DIME Test ID: 2026-06-25-2-3
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: 09/14/2026
Date Tested: 09/08/2026
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
|
BZZP3
|
|
Finish Coating
|
ASTM F2329 - Hot Dip
|
|
Product Markings
|
no data
|
|
Size
|
2 in
|
|
Bolt Length
|
no data in
|
|
Measurement Average
|
6.8 mils
|
DIME Test ID: 2026-06-25-2-4
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: 09/14/2026
Date Tested: 09/08/2026
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
|
BZZP3
|
|
Finish Coating
|
ASTM F2329 - Hot Dip
|
|
Product Markings
|
no data
|
|
Size
|
2 in
|
|
Bolt Length
|
no data in
|
|
Measurement Average
|
5.4 mils
|
DIME Test ID: 2026-06-25-2-5
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 09/14/2026
Date Tested: 09/08/2026
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
|
BZZP3
|
|
Finish Coating
|
ASTM F2329 - Hot Dip
|
|
Product Markings
|
no data
|
|
Size
|
2 in
|
|
Bolt Length
|
no data in
|
|
Hardness Reading Scale
|
C Scale
|
|
Hardness Reading Average
|
28
|
|
Spacing
|
Ok
|
DIME Test ID: 2026-06-25-2-6
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 09/14/2026
Date Tested: 09/08/2026
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
|
BZZP3
|
|
Finish Coating
|
ASTM F2329 - Hot Dip
|
|
Product Markings
|
no data
|
|
Size
|
2 in
|
|
Bolt Length
|
no data in
|
|
Hardness Reading Scale
|
C Scale
|
|
Hardness Reading Average
|
28
|
|
Spacing
|
Ok
|
DIME Test ID: 2026-06-25-2-7
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 09/14/2026
Date Tested: 09/08/2026
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
|
BZZP3
|
|
Finish Coating
|
ASTM F2329 - Hot Dip
|
|
Product Markings
|
no data
|
|
Size
|
2 in
|
|
Bolt Length
|
no data in
|
|
Hardness Reading Scale
|
C Scale
|
|
Hardness Reading Average
|
29
|
|
Spacing
|
Ok
|
DIME Test ID: 2026-06-25-2-8
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 09/14/2026
Date Tested: 09/08/2026
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
|
BZZP3
|
|
Finish Coating
|
ASTM F2329 - Hot Dip
|
|
Product Markings
|
no data
|
|
Size
|
2 in
|
|
Bolt Length
|
no data in
|
|
Hardness Reading Scale
|
C Scale
|
|
Hardness Reading Average
|
28
|
|
Spacing
|
Ok
|
