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Sample Record for 2019-12-11-4

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

Project Information

Project ID: 214077 DEA: 101C5304 EFIS: 1015000002 QA Service Level: 1
DIST-CO-RTE-PM: 10-STA,SJ-5,99-Var
Work Description: OVERHEAD AND ROADSIDE SIGNS, AND MODIFY ELECTRICAL SYSTEMS.
Location Description: SAN JOAQUIN AND STANISLAUS COUNTIES AT VARIOUS LOCATIONS
Contractor Name: Independent Structures Inc.
Contractor Address: 8431 HARTMEYER LN, Redding, CA 96002
Resident Engineer: Mohammad "Wali" Waziri Structure Rep.: Stephen Pozzo

Sample Information

DIME Sample ID: 2019-12-11-4
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 12/11/2019
Date that the sample was received by the laboratory/organization performing the testing: 12/18/2019
The quantity of what the sample constitutes: 68
A brief description of the sample: 1/2" F436 M/G
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Structural and Steel Products

Material Information

Rocap Number(s):
Heat Number(s): 41806190
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s): D6057
Bolt Specification: n/a
Bolt Length(s): 2 3/4"
Nut Specification: ASTM A563
Washer Specification: n/a
Finish: Mech Galv ASTM B695
Diameter/Size: 1/2"
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s): not required
Washer Inner Diameter(s):
Test results on following page(s): 5

Test Results

Test 1 of 5

DIME Test ID: 2019-12-11-4-1
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 12/24/2019
Date Tested: 12/20/2019
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 D6057
Finish Coating ASTM B695 - Mech Galv
Product Markings F436 P
Size .5 in
Bolt Length no data in
Measurement Average 2.8 mils

Test 2 of 5

DIME Test ID: 2019-12-11-4-2
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 12/24/2019
Date Tested: 12/20/2019
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. 1B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number D6057
Finish Coating ASTM B695 - Mech Galv
Product Markings F436 P
Size .5 in
Bolt Length no data in
Measurement Average 2.42 mils

Test 3 of 5

DIME Test ID: 2019-12-11-4-3
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 12/24/2019
Date Tested: 12/20/2019
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. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number D6057
Finish Coating ASTM B695 - Mech Galv
Product Markings F436 P
Size .5 in
Bolt Length no data in
Measurement Average 2.87 mils

Test 4 of 5

DIME Test ID: 2019-12-11-4-4
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 12/24/2019
Date Tested: 12/20/2019
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 D6057
Finish Coating ASTM B695 - Mech Galv
Product Markings F436 P
Size .5 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 38.7
Spacing Ok

Test 5 of 5

DIME Test ID: 2019-12-11-4-5
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 12/24/2019
Date Tested: 12/20/2019
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. 1B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number D6057
Finish Coating ASTM B695 - Mech Galv
Product Markings F436 P
Size .5 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 40.15
Spacing Ok