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Sample Record for 2023-08-01-16

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

Project Information

Project ID: 994119 DEA: 033H3904 EFIS: 0317000340 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-5-22.4
Work Description: STRUCTURAL STEEL BRIDGE AND PRESTRESS STEEL GIRDERS.
Location Description: SACRAMENTO COUNTY IN SACRAMENTO AT THE SOUTH CONNECTOR UNDERCROSSING (BRIDGE NO. 24-0267)
Contractor Name: Golden State Bridge
Contractor Address: 3701 Mallard Drive, Benicia, CA 94510
Resident Engineer: Hani Eissa Structure Rep.: Delia Muñoz

Sample Information

DIME Sample ID: 2023-08-01-16
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: 08/01/2023
Date that the sample was received by the laboratory/organization performing the testing: 08/07/2023
The quantity of what the sample constitutes: 540
A brief description of the sample: 1-8 A563 Nuts
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CK Johnson Industries

Material Information

Rocap Number(s):
Heat Number(s): 8000021190
Nut Mfg. Lot Number(s): W000028253
Washer Mfg. Lot Number(s):
Bolt Specification: NA
Bolt Length(s):
Nut Specification: ASTM A563
Washer Specification: NA
Finish: HDG
Diameter/Size: 1
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):
Test results on following page(s): 8

Test Results

Test 1 of 8

DIME Test ID: 2023-08-01-16-1
Test Method: ASTM F606-21: Standard Test Methods for Determining the Mechanical Properties of Externally and Internally Threaded Fasteners, Washers, Direct Tension Indicators, and Rivets (Proof Load)
Verified Date: 08/09/2023
Date Tested: 08/08/2023
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: Proof Load
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleBolt Mfg. Lot NumberSize (in)Peak Load (lbf)Peak Load (kN)CommentsTested By
1A98242Proof Load
UTM 450kip
Temperature 72 f

Test 2 of 8

DIME Test ID: 2023-08-01-16-2
Test Method: ASTM F606-21: Standard Test Methods for Determining the Mechanical Properties of Externally and Internally Threaded Fasteners, Washers, Direct Tension Indicators, and Rivets (Proof Load)
Verified Date: 08/09/2023
Date Tested: 08/08/2023
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: Proof Load
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleBolt Mfg. Lot NumberSize (in)Peak Load (lbf)Peak Load (kN)CommentsTested By
1B99032Proof Load
UTM 450kip
Temperature 72 f

Test 3 of 8

DIME Test ID: 2023-08-01-16-3
Test Method: ASME B1.2-83r17: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 08/09/2023
Date Tested: 08/08/2023
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 W000028253
Finish Coating ASTM F2329 - Hot Dip
Product Markings DH N
Size 1 in
Gage Type Pass

Test 4 of 8

DIME Test ID: 2023-08-01-16-4
Test Method: ASME B1.2-83r17: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 08/09/2023
Date Tested: 08/08/2023
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 W000028253
Finish Coating ASTM F2329 - Hot Dip
Product Markings DH N
Size 1 in
Gage Type Pass

Test 5 of 8

DIME Test ID: 2023-08-01-16-5
Test Method: ASME B1.2-83r17: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 08/09/2023
Date Tested: 08/08/2023
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. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number W000028253
Finish Coating ASTM F2329 - Hot Dip
Product Markings DH N
Size 1 in
Gage Type Pass

Test 6 of 8

DIME Test ID: 2023-08-01-16-6
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: 08/09/2023
Date Tested: 08/08/2023
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 W000028253
Finish Coating ASTM F2329 - Hot Dip
Product Markings DH N
Size 1 in
Bolt Length no data in
Measurement Average 2.71 mils

Test 7 of 8

DIME Test ID: 2023-08-01-16-7
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: 08/09/2023
Date Tested: 08/08/2023
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 W000028253
Finish Coating ASTM F2329 - Hot Dip
Product Markings DH N
Size 1 in
Bolt Length no data in
Measurement Average 3.59 mils

Test 8 of 8

DIME Test ID: 2023-08-01-16-8
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: 08/09/2023
Date Tested: 08/08/2023
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. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number W000028253
Finish Coating ASTM F2329 - Hot Dip
Product Markings DH N
Size 1 in
Bolt Length no data in
Measurement Average 5.3 mils