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Sample Record for 2019-01-16-9

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

Project Information

Project ID: 211967 DEA: 101E8904 EFIS: 1016000093 QA Service Level: 1
DIST-CO-RTE-PM: 10-SJ-5-26.5/27.0
Work Description: REPAIR BRIDGE CROSSFRAMES.
Location Description: SAN JOAQUIN COUNTY IN STOCKTON AT STOCKTON CHANNEL VIADUCT
Contractor Name: ABHE & SVOBODA, INC.
Contractor Address: 18100 Dairy Lane, Jordan, MN 55352
Resident Engineer: Ariel Mendoza Structure Rep.: Mohsen Abdelfatah

Sample Information

DIME Sample ID: 2019-01-16-9
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: 01/16/2019
Date that the sample was received by the laboratory/organization performing the testing: 01/21/2019
The quantity of what the sample constitutes: 10
A brief description of the sample: A449 HDG Rocap Assembiy
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Cordova Bolt

Material Information

Rocap Number(s): 304-19-1
Heat Number(s): 3020048
Nut Mfg. Lot Number(s): 411793D
Washer Mfg. Lot Number(s): 0818-936
Bolt Specification: A449
Bolt Length(s): 10-1/2"
Nut Specification: A563
Washer Specification: F436
Finish: HDG
Diameter/Size: 1"
Bolt Mfg. Lot Number: 11229
Rocap Test Requirement(s): yes
Lubricant Requirements(s): Yes
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2019-01-16-9-1
Test Method: ASTM F606-14a: Standard Test Methods for Determining the Mechanical Properties of Externally and Internally Threaded Fasteners, Washers, Direct Tension Indicators, and Rivets (Proof Load with Wedge)
Verified Date: 01/25/2019
Date Tested: 01/25/2019
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: A449
Test Result Compliance:
Additional Comments When Verified:
Number of Bolt Samples 1
SampleBolt Mfg. Lot NumberSize (in)Peak Load (lbf)Peak Load (kN)Wedge Angle (deg)CommentsTested By
8A404965A1\"101510451.510A449Fred
UTM 400KIP
Temperature no data

Test 2 of 3

DIME Test ID: 2019-01-16-9-2
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Verified Date: 01/25/2019
Date Tested: 01/25/2019
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. 8A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 11229
Finish Coating ASTM F2329 - Hot Dip
Product Markings A449
Size 1 in
Bolt Length 10.5 in
Gage Type Pass

Test 3 of 3

DIME Test ID: 2019-01-16-9-3
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 01/25/2019
Date Tested: 01/25/2019
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. 8A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 11229
Finish Coating ASTM F2329 - Hot Dip
Product Markings A449
Size 1 in
Bolt Length 10.5 in
Measurement Average 4.73 mils