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Sample Record for 2020-06-05-11

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Project Information

Project ID: 214015 DEA: 034H9504 EFIS: 0319000123 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC,SAC/YOL-12,160-0-0.4/26.3-26.4, Var, various
Work Description: Repair and modernize electromechanical bridge.
Location Description: In Sacramento County at four bridges.
Contractor Name: Golden State Bridge
Contractor Address: 3701 Mallard Drive, Benicia, CA 94510
Resident Engineer: Masoud Saed Structure Rep.: Rusty D'Anna

Sample Information

DIME Sample ID: 2020-06-05-11
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 06/05/2020
Date that the sample was received by the laboratory/organization performing the testing: 06/08/2020
The quantity of what the sample constitutes: 102
A brief description of the sample: 7/8" HDG Washers
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Bay Bolt

Material Information

Rocap Number(s):
Heat Number(s): B52967
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s): 0619-188
Bolt Specification: N/A
Bolt Length(s):
Nut Specification: N/A
Washer Specification: ASTM F436
Finish: HDG
Diameter/Size: 7/8"
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Results

Test 1 of 3

DIME Test ID: 2020-06-05-11-1
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: 06/10/2020
Date Tested: 06/10/2020
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. 5A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 0619-188
Finish Coating ASTM F2329 - Hot Dip
Product Markings TSI F436
Size .875 in
Bolt Length no data in
Measurement Average 5.51 mils

Test 2 of 3

DIME Test ID: 2020-06-05-11-2
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: 06/10/2020
Date Tested: 06/10/2020
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. 5B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 0619-188
Finish Coating ASTM F2329 - Hot Dip
Product Markings TSI F436
Size .875 in
Bolt Length no data in
Measurement Average 6.2 mils

Test 3 of 3

DIME Test ID: 2020-06-05-11-3
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: 06/10/2020
Date Tested: 06/10/2020
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. 5C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 0619-188
Finish Coating ASTM F2329 - Hot Dip
Product Markings TSI F436
Size .875 in
Bolt Length no data in
Measurement Average 7.65 mils