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Sample Record for 2023-04-12-1

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

Project Information

Project ID: 993279 DEA: 010E0904 EFIS: 0113000123 QA Service Level: 1
DIST-CO-RTE-PM: 01-MEN-20-33.3/34.4
Work Description: CONSTRUCT NEW BRIDGE, REMOVE TWO BRIDGES, EARTHWORK AND PAVING. (Bridge No. 10-0310)
Location Description: MENDOCINO COUNTY NEAR UKIAH FROM 0.3 MILE WEST OF RUSSIAN RIVER BRIDGE AND OVERHEAD TO 0.3 MILE EAST OF COUNTY ROAD 144
Contractor Name: Myers & Sons Construction LLC
Contractor Address: 4600 Northgate Blvd, Suite 100, Sacramento, CA 95838
Resident Engineer: Geoffrey Wright Structure Rep.: Kari Forbes

Sample Information

DIME Sample ID: 2023-04-12-1
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: 04/12/2023
Date that the sample was received by the laboratory/organization performing the testing: 04/17/2023
The quantity of what the sample constitutes: 55
A brief description of the sample: ASTM F436 Washer
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: St. Louis Screw & Bolt

Material Information

Rocap Number(s): N/A
Heat Number(s): B57380
Nut Mfg. Lot Number(s): N/A
Washer Mfg. Lot Number(s): E0076
Bolt Specification: N/A
Bolt Length(s): N/A
Nut Specification: N/A
Washer Specification: ASTM F436
Finish: HDG
Diameter/Size: 5/8"
Bolt Mfg. Lot Number: N/A
Rocap Test Requirement(s): no
Lubricant Requirements(s): no
Washer Inner Diameter(s):

Test Results

Test 1 of 4

DIME Test ID: 2023-04-12-1-1
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: 04/25/2023
Date Tested: 04/17/2023
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 E0076
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size 0.625 in
Bolt Length no data in
Measurement Average 3.75 mils

Test 2 of 4

DIME Test ID: 2023-04-12-1-2
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: 04/25/2023
Date Tested: 04/17/2023
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 E0076
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size 0.625 in
Bolt Length no data in
Measurement Average 3.4 mils

Test 3 of 4

DIME Test ID: 2023-04-12-1-3
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 04/25/2023
Date Tested: 04/17/2023
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 E0076
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size 0.625 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 41.58
Spacing Ok

Test 4 of 4

DIME Test ID: 2023-04-12-1-4
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 04/25/2023
Date Tested: 04/17/2023
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 E0076
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size 0.625 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 41.66
Spacing Ok