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Sample Record for 2019-07-02-3

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

Project Information

DEA: No Project QA Service Level:
DIST-CO-RTE-PM: ---
Work Description: Special project identifier for material not associated with a project
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-07-02-3
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: 07/02/2019
Date that the sample was received by the laboratory/organization performing the testing: 07/09/2019
The quantity of what the sample constitutes: 12
A brief description of the sample: 1/2" Hex Nut A563-DH MG
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: UIS

Material Information

Rocap Number(s): TT0116534, TT0116535, TT0116536
Heat Number(s): 10551920
Nut Mfg. Lot Number(s): 19-46-007
Washer Mfg. Lot Number(s):
Bolt Specification: NA
Bolt Length(s):
Nut Specification: A563
Washer Specification: NA
Finish:
Diameter/Size:
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):
Test results on following page(s): 7

Test Results

Test 1 of 7

DIME Test ID: 2019-07-02-3-1
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)
Verified Date: 07/23/2019
Date Tested: 07/15/2019
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: Nut Proof Load
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleBolt Mfg. Lot NumberSize (in)Peak Load (lbf)Peak Load (kN)CommentsTested By
1A19-46-0071/2\"2161796.16Nut Proof LoadBrian
UTM 400KIP
Temperature 72 F

Test 2 of 7

DIME Test ID: 2019-07-02-3-2
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)
Verified Date: 07/23/2019
Date Tested: 07/15/2019
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: Nut Proof Load
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleBolt Mfg. Lot NumberSize (in)Peak Load (lbf)Peak Load (kN)CommentsTested By
1B19-46-0071/2\"2154195.82Nut Proof LoadBrian
UTM 400KIP
Temperature 72 F

Test 3 of 7

DIME Test ID: 2019-07-02-3-3
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: 07/23/2019
Date Tested: 07/16/2019
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. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 19-46-007
Finish Coating ASTM B695 - Mech Galv
Product Markings DMC DH
Size .5 in
Bolt Length no data in
Measurement Average 2.58 mils

Test 4 of 7

DIME Test ID: 2019-07-02-3-4
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: 07/23/2019
Date Tested: 07/16/2019
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. 1B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 19-46-007
Finish Coating ASTM B695 - Mech Galv
Product Markings DMC DH
Size .5 in
Bolt Length no data in
Measurement Average 3.19 mils

Test 5 of 7

DIME Test ID: 2019-07-02-3-5
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: 07/23/2019
Date Tested: 07/16/2019
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. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 19-46-007
Finish Coating ASTM B695 - Mech Galv
Product Markings DMC DH
Size .5 in
Bolt Length no data in
Measurement Average 3.18 mils

Test 6 of 7

DIME Test ID: 2019-07-02-3-6
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: 07/23/2019
Date Tested: 07/16/2019
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. 1D
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 19-46-007
Finish Coating ASTM B695 - Mech Galv
Product Markings DMC DH
Size .5 in
Bolt Length no data in
Measurement Average 2.75 mils

Test 7 of 7

DIME Test ID: 2019-07-02-3-7
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: 07/23/2019
Date Tested: 07/16/2019
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. 1E
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 19-46-007
Finish Coating ASTM B695 - Mech Galv
Product Markings DMC DH
Size .5 in
Bolt Length no data in
Measurement Average 2.71 mils