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Sample Record for 2020-06-12-2

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

Project Information

Project ID: 212324 DEA: 033F5104 EFIS: 0313000020 QA Service Level: 1
DIST-CO-RTE-PM: 03-YUB-20-R18.1/R20.1
Work Description: Construct bridge, realign curve & widen shoulders.
Location Description: Construction on state highway in Yuba County near Smartsville from the Yuba River Bridge to 0.3 mile east of Smartsville Road.
Contractor Name: Flatiron West, Inc.
Contractor Address: 2100 Goodyear Road, Benicia, CA 94510
Resident Engineer: Aaron Chamberlin Structure Rep.: Brent Bullard

Sample Information

DIME Sample ID: 2020-06-12-2
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 06/12/2020
Date that the sample was received by the laboratory/organization performing the testing: 06/16/2020
The quantity of what the sample constitutes: 4
A brief description of the sample: 3/4" HDG Washer
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Gerlinger

Material Information

Rocap Number(s):
Heat Number(s):
Nut Mfg. Lot Number(s): n/a
Washer Mfg. Lot Number(s): 1118-002
Bolt Specification: n/a
Bolt Length(s): Unknown
Nut Specification: n/a
Washer Specification: ASTM F436
Finish: Hot Dipped ASTM A153 / ASTM F2329
Diameter/Size: 3/4"
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2020-06-12-2-1
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: 06/17/2020
Date Tested: 06/17/2020
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. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 1118-002
Finish Coating ASTM F2329 - Hot Dip
Product Markings TSI F436
Size .75 in
Bolt Length no data in
Measurement Average 3.16 mils

Test 2 of 2

DIME Test ID: 2020-06-12-2-2
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 06/17/2020
Date Tested: 06/17/2020
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. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 1118-002
Finish Coating ASTM F2329 - Hot Dip
Product Markings TSI F436
Size .75 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 40.3
Spacing Ok