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Sample Record for 2020-07-28-9

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

Project Information

Project ID: 213737 DEA: 07289104 EFIS: 0700021123 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-405-11.9/13.2
Work Description: Rehabilitate the existing Commercial Vehicle Enforcement Facility.
Location Description: LOS ANGELES COUNTY IN CARSON FROM DEL AMO BOULEVARD OVER CROSSING TO VERMONT AVENUE (190TH) UNDER CROSSING.
Contractor Name: POWELL CONSTRUCTORS, INC.
Contractor Address: 8555 Banana Avenue, Fontana, CA 92335
Resident Engineer: Samuel Gallardo Structure Rep.: Bernabe Contreras Jr

Sample Information

DIME Sample ID: 2020-07-28-9
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: 07/28/2020
Date that the sample was received by the laboratory/organization performing the testing: 07/31/2020
The quantity of what the sample constitutes: 130
A brief description of the sample: 5/8 F436 Washer Plain
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Prestige Stamping

Material Information

Rocap Number(s): B416144A N425659A WD8070 B392101A N425659A WD8070 B385001A N425659A WD8070
Heat Number(s): X0423
Nut Mfg. Lot Number(s): n/a
Washer Mfg. Lot Number(s): D8070
Bolt Specification: n/a
Bolt Length(s): n/a
Nut Specification: n/a
Washer Specification: ASTM F436
Finish: Plain
Diameter/Size: 5/8
Bolt Mfg. Lot Number: n/a
Rocap Test Requirement(s):
Lubricant Requirements(s):
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2020-07-28-9-1
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 08/06/2020
Date Tested: 08/05/2020
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 D8070
Finish Coating Plain
Product Markings F436 P
Size .625 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 39.15
Spacing Ok

Test 2 of 2

DIME Test ID: 2020-07-28-9-2
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 08/06/2020
Date Tested: 08/05/2020
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. 1B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number D8070
Finish Coating Plain
Product Markings F436 P
Size .625 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 39.6
Spacing Ok