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Sample Record for 2020-01-08-2

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

Project Information

Project ID: 214175 DEA: 030H4804 EFIS: 0315000198 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-99-0.1/1.6,11.8/21.6
Work Description: COLD PLANE AC PAVEMENT AND RHMA OVERLAY.
Location Description: SACRAMENTO COUNTY IN AND NEAR GALT FROM DRY CREEK BRIDGE TO SIMMERHORN ROAD AND IN ELK GROVE AND SACRAMENTO FROM 0.9 MILE SOUTH OF ELK GROVE BOULEVARD TO MARTIN LUTHER KING JR BOULEVARD
Contractor Name: MERCER-FRASER COMPANY
Contractor Address: PO Box 1006, Eureka, CA 95502
Resident Engineer: Sushma Lee Structure Rep.: Kim Noonan

Sample Information

DIME Sample ID: 2020-01-08-2
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7263
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 01/08/2020
Date that the sample was received by the laboratory/organization performing the testing: 01/16/2020
The quantity of what the sample constitutes: 115
A brief description of the sample: A563 DH Plain Nuts
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: EDSCO Fasteners

Material Information

Rocap Number(s): N/A
Heat Number(s): 188907
Nut Mfg. Lot Number(s): DEAM
Washer Mfg. Lot Number(s):
Bolt Specification: NA
Bolt Length(s): Unknown
Nut Specification: A563 DH
Washer Specification: NA
Finish: Plain
Diameter/Size: 2.5"
Bolt Mfg. Lot Number: N/A
Rocap Test Requirement(s): No
Lubricant Requirements(s): Yes

Test Results

Test 1 of 5

DIME Test ID: 2020-01-08-2-1
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 01/22/2020
Date Tested: 01/22/2020
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 DEAM
Finish Coating Plain
Product Markings DH D/N 2H
Size 2.5 in
Gage Type Pass

Test 2 of 5

DIME Test ID: 2020-01-08-2-2
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 01/22/2020
Date Tested: 01/22/2020
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 DEAM
Finish Coating Plain
Product Markings DH D/N 2H
Size 2.5 in
Gage Type Pass

Test 3 of 5

DIME Test ID: 2020-01-08-2-3
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 01/22/2020
Date Tested: 01/22/2020
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. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number DEAM
Finish Coating Plain
Product Markings DH D/N 2H
Size 2.5 in
Gage Type Pass

Test 4 of 5

DIME Test ID: 2020-01-08-2-4
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 01/22/2020
Date Tested: 01/22/2020
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 DEAM
Finish Coating Plain
Product Markings DH D/N 2H
Size 2.5 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 28.07
Spacing Ok

Test 5 of 5

DIME Test ID: 2020-01-08-2-5
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 01/22/2020
Date Tested: 01/22/2020
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 DEAM
Finish Coating Plain
Product Markings DH D/N 2H
Size 2.5 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 27.73
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.