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Sample Record for 2023-09-07-8

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: 2023-09-07-8
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: 09/07/2023
Date that the sample was received by the laboratory/organization performing the testing: 09/11/2023
The quantity of what the sample constitutes: 336
A brief description of the sample: 1" F436 Washer
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): 230288
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s): 230228-32957
Bolt Specification: NA
Bolt Length(s):
Nut Specification: NA
Washer Specification: ASTM F436
Finish: HDG
Diameter/Size: 1
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):
Test results on following page(s): 6

Test Results

Test 1 of 6

DIME Test ID: 2023-09-07-8-1
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: 09/19/2023
Date Tested: 09/18/2023
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 230288
Finish Coating ASTM F2329 - Hot Dip
Product Markings WS
Size 1 in
Bolt Length no data in
Measurement Average 2.37 mils

Test 2 of 6

DIME Test ID: 2023-09-07-8-2
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: 09/19/2023
Date Tested: 09/18/2023
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 230288
Finish Coating ASTM F2329 - Hot Dip
Product Markings WS
Size 1 in
Bolt Length no data in
Measurement Average 3.35 mils

Test 3 of 6

DIME Test ID: 2023-09-07-8-3
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: 09/19/2023
Date Tested: 09/18/2023
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 230288
Finish Coating ASTM F2329 - Hot Dip
Product Markings WS
Size 1 in
Bolt Length no data in
Measurement Average 2.7 mils

Test 4 of 6

DIME Test ID: 2023-09-07-8-4
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 09/19/2023
Date Tested: 09/18/2023
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 230288
Finish Coating ASTM F2329 - Hot Dip
Product Markings WS
Size 1 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 35.4
Spacing Ok

Test 5 of 6

DIME Test ID: 2023-09-07-8-5
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 09/19/2023
Date Tested: 09/18/2023
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 230288
Finish Coating ASTM F2329 - Hot Dip
Product Markings WS
Size 1 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 36.2
Spacing Ok

Test 6 of 6

DIME Test ID: 2023-09-07-8-6
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 09/19/2023
Date Tested: 09/18/2023
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 230288
Finish Coating ASTM F2329 - Hot Dip
Product Markings WS
Size 1 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 39.05
Spacing Ok