Print Report | Back to Sample Detail

Sample Record for 2020-09-14-12

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

Project Information

Project ID: 214228 DEA: 120N4904 EFIS: 1214000050 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-91-R12.5/R13.9
Work Description: VEHICLE ENFORCEMENT FACILITY IMPROVEMENT AT PERALTA WEIGH STATION.
Location Description: ORANGE COUNTY IN ANAHEIM FROM 1.0 MILE EAST OF ROUTE 91/90 SEPARATION TO 0.5 MILE WEST OF WEIR CANYON ROAD UNDERCROSSING
Contractor Name: SPECTRUM CONSTRUCTION GROUP, INC.
Contractor Address: 32 EDELMAN, IRVINE, CA 92618
Resident Engineer: Dat Pham Structure Rep.: Bijan Ronagh-Langroodi

Sample Information

DIME Sample ID: 2020-09-14-12
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: 09/14/2020
Date that the sample was received by the laboratory/organization performing the testing: 09/18/2020
The quantity of what the sample constitutes: 109
A brief description of the sample: 5/8" HHN's
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Bristol Machine

Material Information

Rocap Number(s):
Heat Number(s): 6215104804
Nut Mfg. Lot Number(s): 31980-6215104804
Washer Mfg. Lot Number(s): N/A
Bolt Specification: N/A
Bolt Length(s): N/A
Nut Specification: ASTM A563 Gr. DH
Washer Specification: N/A
Finish: Black
Diameter/Size: 5/8"
Bolt Mfg. Lot Number: N/A
Rocap Test Requirement(s):
Lubricant Requirements(s):
Test results on following page(s): 4

Test Results

Test 1 of 4

DIME Test ID: 2020-09-14-12-1
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: 09/30/2020
Date Tested: 09/28/2020
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: 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
1A31980-621510480441662Nut Proof Loadspaine
UTM 450kip
Temperature 72 f

Test 2 of 4

DIME Test ID: 2020-09-14-12-2
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 09/30/2020
Date Tested: 09/28/2020
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 31980-6215104804
Finish Coating Plain
Product Markings DH U
Size .625 in
Gage Type Pass

Test 3 of 4

DIME Test ID: 2020-09-14-12-3
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 09/30/2020
Date Tested: 09/28/2020
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 31980-6215104804
Finish Coating Plain
Product Markings DH U
Size .625 in
Gage Type Pass

Test 4 of 4

DIME Test ID: 2020-09-14-12-4
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 09/30/2020
Date Tested: 09/28/2020
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. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 31980-6215104804
Finish Coating Plain
Product Markings DH U
Size .625 in
Gage Type Pass