Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214787 DEA: 032H0804 EFIS: 0317000059
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-160-L3.9
Work Description: INSTALL CHANGEABLE MESSAGE AND CAMERA SYSTEMS, & PLACE SIGN STRUCTURE.
Location Description: SACRAMENTO COUNTY NEAR ANTIOCH AT 3.9 MILES NORTH OF CONTRA COSTA COUNTY LINE
Contractor Name: PETERSON-CHASE GENERAL ENGINEERING CONSTRUCTION, INC.
Contractor Address: 16351 Construction Circle West, Irvine, CA 92606
Resident Engineer: Howard Giang Structure Rep.: Unknown
DIME Sample ID: 2020-11-05-3
TL Number from the TL Form: na
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: 11/05/2020
Date that the sample was received by the laboratory/organization performing the testing: 11/16/2020
The quantity of what the sample constitutes: 810
A brief description of the sample: Anchor Bolt Hardware 2-1/2" (Retest)
From where was the sample collected: Fabricator
Laboratory sample identification: na
Structure unique identifier:
Structure name: na
The fabricator/manufacturer/facility name: Universal Industrial Sales
Rocap Number(s): na
Heat Number(s): 201548
Nut Mfg. Lot Number(s): DECN
Washer Mfg. Lot Number(s): na
Bolt Specification: na
Bolt Length(s): na
Nut Specification: A563-DH
Washer Specification: na
Finish: Plain
Diameter/Size: 2-1/2"
Bolt Mfg. Lot Number: na
Rocap Test Requirement(s): na
Lubricant Requirements(s): na
DIME Test ID: 2020-11-05-3-1
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 11/18/2020
Date Tested: 11/18/2020
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
|
DECN
|
Finish Coating
|
Plain
|
Product Markings
|
2H DH D/N
|
Size
|
2.5 in
|
Gage Type
|
Pass
|
DIME Test ID: 2020-11-05-3-2
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 11/18/2020
Date Tested: 11/18/2020
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
|
DECN
|
Finish Coating
|
Plain
|
Product Markings
|
2H DH D/N
|
Size
|
2.5 in
|
Gage Type
|
Pass
|
DIME Test ID: 2020-11-05-3-3
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 11/18/2020
Date Tested: 11/18/2020
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
|
DECN
|
Finish Coating
|
Plain
|
Product Markings
|
2H DH D/N
|
Size
|
2.5 in
|
Gage Type
|
Pass
|
DIME Test ID: 2020-11-05-3-4
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 11/18/2020
Date Tested: 11/18/2020
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.
|
1D
|
Rocap Number
|
no data
|
Heat Number(s)
|
no data
|
Mfg. Lot Number
|
DECN
|
Finish Coating
|
Plain
|
Product Markings
|
2H DH D/N
|
Size
|
2.5 in
|
Gage Type
|
Pass
|
DIME Test ID: 2020-11-05-3-5
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 11/18/2020
Date Tested: 11/18/2020
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.
|
1E
|
Rocap Number
|
no data
|
Heat Number(s)
|
no data
|
Mfg. Lot Number
|
DECN
|
Finish Coating
|
Plain
|
Product Markings
|
2H DH D/N
|
Size
|
2.5 in
|
Gage Type
|
Pass
|
DIME Test ID: 2020-11-05-3-6
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 11/18/2020
Date Tested: 11/18/2020
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
|
DECN
|
Finish Coating
|
Plain
|
Product Markings
|
2H DH D/N
|
Size
|
2.5 in
|
Bolt Length
|
no data in
|
Hardness Reading Scale
|
C Scale
|
Hardness Reading Average
|
25.9
|
Spacing
|
Ok
|
DIME Test ID: 2020-11-05-3-7
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 11/18/2020
Date Tested: 11/18/2020
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
|
DECN
|
Finish Coating
|
Plain
|
Product Markings
|
2H DH D/N
|
Size
|
2.5 in
|
Bolt Length
|
no data in
|
Hardness Reading Scale
|
C Scale
|
Hardness Reading Average
|
26.4
|
Spacing
|
Ok
|
DIME Test ID: 2020-11-05-3-8
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 11/18/2020
Date Tested: 11/18/2020
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
|
DECN
|
Finish Coating
|
Plain
|
Product Markings
|
2H DH D/N
|
Size
|
2.5 in
|
Bolt Length
|
no data in
|
Hardness Reading Scale
|
C Scale
|
Hardness Reading Average
|
26.38
|
Spacing
|
Ok
|