Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000244 DEA: 120T9704 EFIS: 1223000009 MINOR: 12A2155
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-5,74-0.1, 2.3
Work Description: INSTALL CCTVs, CAMERAS, AND RADIOS
Location Description:
Contractor Name: PK Construction
Contractor Address: 1227 Jacaranda Place, Upland, CA 91784
Resident Engineer: Bibars Kattao Structure Rep.: Vian Ghazi
DIME Sample ID: 2024-10-17-2
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: 10/17/2024
Date that the sample was received by the laboratory/organization performing the testing: 10/25/2024
The quantity of what the sample constitutes: 25
A brief description of the sample: F1554 anchor rods
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Madden Bolt
Rocap Number(s):
Heat Number(s): 58058652
Nut Mfg. Lot Number(s): n/a
Washer Mfg. Lot Number(s): n/a
Bolt Specification: ASTM F1554 Grade 55
Bolt Length(s): 60"
Nut Specification: n/a
Washer Specification: n/a
Finish: HDG
Diameter/Size: 3"
Bolt Mfg. Lot Number: 58058652
Rocap Test Requirement(s):
Lubricant Requirements(s):
DIME Test ID: 2024-10-17-2-1
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: 12/28/2024
Date Tested: 12/27/2024
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: Atlas Technical Consultants
Test Result Compliance:
Additional Comments When Verified:
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Sample No.
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1A
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Rocap Number
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no data
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|
Heat Number(s)
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58058652
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Mfg. Lot Number
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no data
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|
Finish Coating
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Plain
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|
Product Markings
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no data
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|
Size
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0.501 in
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Bolt Length
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no data in
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Measurement Average
|
7.3 mils
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DIME Test ID: 2024-10-17-2-2
Test Method: ASTM A370-20: Standard Test Methods and Definitions for Mechanical Testing of Steel Products (Reduced Tensile)
Verified Date: 12/28/2024
Date Tested: 12/27/2024
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:
|
Number of Samples
|
1
|
| Sample | Heat Number | Diameter (in) | Area (sqin) | Stress at Offset (psi) | Tensile Strength (psi) | Elongation in 4 x d (%) | Tested By | | 1A | 58058652 | 0.501 | 0.1971 | 61800 | 85300 | 27 | Atlas Technical Consultants |
| |
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UTM
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NA
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|
Temperature
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0 f
|
