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Sample Record for 2023-06-01-1

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

Project Information

Project ID: 215788 DEA: 101C7904 EFIS: 1016000046 QA Service Level: 1
DIST-CO-RTE-PM: 10-MER-5-0.4
Work Description: BUILDING WORK.
Location Description: MERCED COUNTY 0.4 MILE NORTH OF THE FRESNO COUNTY LINE AT THE JOHN "CHUCK" ERRECA SAFETY ROADSIDE REST AREA
Contractor Name: Walsh Construction Company II, LLC (Walsh) - Bryce Frederick
Contractor Address: 1390 Willow Pass Road Suite 950, Concord, CA 94520
Resident Engineer: Zubair Anwar Structure Rep.: Ramandeep "Raman" Guraya

Sample Information

DIME Sample ID: 2023-06-01-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 06/01/2023
Date that the sample was received by the laboratory/organization performing the testing: 06/05/2023
The quantity of what the sample constitutes: 180
A brief description of the sample: F3125 HS Cap Screws
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: KW Industries

Material Information

Rocap Number(s): NA
Heat Number(s): 1000214449
Nut Mfg. Lot Number(s): NA
Washer Mfg. Lot Number(s): NA
Bolt Specification: A325
Bolt Length(s): 2"
Nut Specification: NA
Washer Specification: NA
Finish: ASTM B695 - Mech Galv.
Diameter/Size: 5/8"
Bolt Mfg. Lot Number: 467820A
Rocap Test Requirement(s): NA
Lubricant Requirements(s): Blue Dye
Washer Inner Diameter(s):

Test Results

Test 1 of 6

DIME Test ID: 2023-06-01-1-1
Test Method: ASME B1.2-83r17: (Pitch Diameter) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Pitch Diameter)
Verified Date: 06/19/2023
Date Tested: 06/06/2023
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 467820A
Finish Coating ASTM B695 - Mech Galv
Product Markings A325 N USA
Size 0.625 in
Bolt Length 2 in
Pitch Diameter .565 in
Pitch Diameter 2nd .565 in

Test 2 of 6

DIME Test ID: 2023-06-01-1-2
Test Method: ASME B1.2-83r17: (Pitch Diameter) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Pitch Diameter)
Verified Date: 06/19/2023
Date Tested: 06/06/2023
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 467820A
Finish Coating ASTM B695 - Mech Galv
Product Markings A325 N USA
Size 0.625 in
Bolt Length 2 in
Pitch Diameter .563 in
Pitch Diameter 2nd .563 in

Test 3 of 6

DIME Test ID: 2023-06-01-1-3
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: 06/19/2023
Date Tested: 06/06/2023
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 467820A
Finish Coating ASTM B695 - Mech Galv
Product Markings A325 N USA
Size 0.625 in
Bolt Length 2 in
Measurement Average 2.12 mils

Test 4 of 6

DIME Test ID: 2023-06-01-1-4
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: 06/19/2023
Date Tested: 06/06/2023
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 467820A
Finish Coating ASTM B695 - Mech Galv
Product Markings A325 N USA
Size 0.625 in
Bolt Length 2 in
Measurement Average 1.31 mils

Test 5 of 6

DIME Test ID: 2023-06-01-1-5
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 06/19/2023
Date Tested: 06/06/2023
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 467820A
Finish Coating ASTM B695 - Mech Galv
Product Markings A325 N USA
Size 0.625 in
Bolt Length 2 in
Hardness Reading Scale C Scale
Hardness Reading Average 30.37
Spacing Ok

Test 6 of 6

DIME Test ID: 2023-06-01-1-6
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 06/19/2023
Date Tested: 06/06/2023
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 467820A
Finish Coating ASTM B695 - Mech Galv
Product Markings A325 N USA
Size 0.625 in
Bolt Length 2 in
Hardness Reading Scale C Scale
Hardness Reading Average 27.87
Spacing Ok