Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
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
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: 5625005861
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
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):
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 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
|
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
|
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 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
|
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
|