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Sample Record for 2023-11-09-5

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

Project Information

Project ID: 88888 DEA: SMTL-STOCK EFIS: SMTL-STOCK QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for SMTL stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2023-11-09-5
TL Number from the TL Form:
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: 11/09/2023
Date that the sample was received by the laboratory/organization performing the testing: 11/20/2023
The quantity of what the sample constitutes: 850
A brief description of the sample: TRI-LOC A563-DH nuts
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Universal Industrial Sales, Inc.

Material Information

Rocap Number(s): na
Heat Number(s): 6215287403
Nut Mfg. Lot Number(s): 33750-6215287403
Washer Mfg. Lot Number(s): na
Bolt Specification: na
Bolt Length(s): na
Nut Specification: A563-DH
Washer Specification: na
Finish: HDG
Diameter/Size: 5/8"
Bolt Mfg. Lot Number: na
Rocap Test Requirement(s): na
Lubricant Requirements(s): none
Test results on following page(s): 6

Test Results

Test 1 of 6

DIME Test ID: 2023-11-09-5-1
Test Method: ASME B1.2-83r17: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 12/12/2023
Date Tested: 12/08/2023
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 33750-6215287403
Finish Coating ASTM F2329 - Hot Dip
Product Markings U DH
Size 0.625 in
Gage Type Fail (Go)

Test 2 of 6

DIME Test ID: 2023-11-09-5-2
Test Method: ASME B1.2-83r17: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 12/12/2023
Date Tested: 12/08/2023
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 33750-6215287403
Finish Coating ASTM F2329 - Hot Dip
Product Markings U DH
Size 0.625 in
Gage Type Fail (Go)

Test 3 of 6

DIME Test ID: 2023-11-09-5-3
Test Method: ASME B1.2-83r17: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 12/12/2023
Date Tested: 12/08/2023
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 33750-6215287403
Finish Coating ASTM F2329 - Hot Dip
Product Markings U DH
Size 0.625 in
Gage Type Fail (Go)

Test 4 of 6

DIME Test ID: 2023-11-09-5-4
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: 12/12/2023
Date Tested: 12/08/2023
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 33750-6215287403
Finish Coating ASTM F2329 - Hot Dip
Product Markings U DH
Size 0.625 in
Bolt Length no data in
Measurement Average 2.95 mils

Test 5 of 6

DIME Test ID: 2023-11-09-5-5
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: 12/12/2023
Date Tested: 12/08/2023
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 33750-6215287403
Finish Coating ASTM F2329 - Hot Dip
Product Markings U DH
Size 0.625 in
Bolt Length no data in
Measurement Average 3.33 mils

Test 6 of 6

DIME Test ID: 2023-11-09-5-6
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: 12/12/2023
Date Tested: 12/08/2023
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 33750-6215287403
Finish Coating ASTM F2329 - Hot Dip
Product Markings U DH
Size 0.625 in
Bolt Length no data in
Measurement Average 3.44 mils