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Sample Record for 2018-01-11-9

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

Project Information

Project ID: 210580 DEA: 022E8004 EFIS: 0200000603 QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-5-R7.2
Work Description: RECONSTRUCTION OF THE DUNSMUIR COMMERCIAL VEHICLE ENFORCEMENT FACILITY
Location Description: IN SISKIYOU COUNTY NEAR DUNSMUIR ATDUNSMUIR GRADE COMMERCIAL VEHICLE ENFORCEMENT FACILITY.
Contractor Name: RANDY HILL CONSTRUCTION, INC
Contractor Address: 5237 Mallard Estates Rd., Chico, CA 95973
Resident Engineer: Nicole Mallory Structure Rep.: Andrew J (Andy) Osullivan

Sample Information

DIME Sample ID: 2018-01-11-9
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT - Unassigned/General Field Laboratory
Sample Organization Contact: (510) 385-8178
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 01/11/2018
Date that the sample was received by the laboratory/organization performing the testing: 01/16/2018
The quantity of what the sample constitutes: 9
A brief description of the sample: F436 Washer
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Nowdesha Metal Solutions

Material Information

Rocap Number(s):
Heat Number(s):
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s): 0617-567
Bolt Specification: A325
Bolt Length(s): Unknown
Nut Specification: A563
Washer Specification: F436
Finish:
Diameter/Size: Unknown
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Results

Test 1 of 2

DIME Test ID: 2018-01-11-9-1
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 01/18/2018
Date Tested: 01/17/2018
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: paul.lukkarila@dot.ca.gov
Organization Phone: (916) 227-7253
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 0617-567
Finish Coating Plain
Product Markings TSI F436
Size .75 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 41.65
Spacing Ok

Test 2 of 2

DIME Test ID: 2018-01-11-9-2
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 01/18/2018
Date Tested: 01/17/2018
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: paul.lukkarila@dot.ca.gov
Organization Phone: (916) 227-7253
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 0617-567
Finish Coating Plain
Product Markings TSI F436
Size .75 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 40.45
Spacing Ok

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.