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Sample Record for 2021-02-19-26

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

Project Information

Project ID: 212085 DEA: 07296604 EFIS: 0713000057 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-10-14.0/19.0
Work Description: PAINT AND REHABILITATE BRIDGE - (STRAIN (PAINT AND INSTALL CATWALK)
Location Description: IN THE CITY OF LOS ANGELES, AT SANTA MONICA VIADUCT (BR. NO. 53-1301). PAINT AND REHABILITATE BRIDGE
Contractor Name: CL Industrial Coating Inc.
Contractor Address: 11650 Western Ave., Stanton, CA 90680
Resident Engineer: Pravin Patel Structure Rep.: Shmara, Nabil

Sample Information

DIME Sample ID: 2021-02-19-26
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Los Angeles Field Laboratory
Sample Organization Contact: (858) 285-5797
Type of Sample: Verification
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 02/19/2021
Date that the sample was received by the laboratory/organization performing the testing: 02/19/2021
The quantity of what the sample constitutes: 600
A brief description of the sample: ASTM F436 Bevel Washer
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Page Industrial

Material Information

Rocap Number(s):
Heat Number(s):
Nut Mfg. Lot Number(s): n/a
Washer Mfg. Lot Number(s): 8741
Bolt Specification: n/a
Bolt Length(s): n/a
Nut Specification: n/a
Washer Specification: ASTM F436
Finish: Hot Dipped Galvanized
Diameter/Size: 3/4"
Bolt Mfg. Lot Number: n/a
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Results

Test 1 of 5

DIME Test ID: 2021-02-19-26-1
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: 03/16/2021
Date Tested: 03/16/2021
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:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 8741
Finish Coating ASTM F2329 - Hot Dip
Product Markings W
Size .75 in
Bolt Length no data in
Measurement Average 3.95 mils

Test 2 of 5

DIME Test ID: 2021-02-19-26-2
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: 03/16/2021
Date Tested: 03/16/2021
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:
Additional Comments When Verified:
Sample No. 1B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 8741
Finish Coating ASTM F2329 - Hot Dip
Product Markings W
Size .75 in
Bolt Length no data in
Measurement Average 3.5 mils

Test 3 of 5

DIME Test ID: 2021-02-19-26-3
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: 03/16/2021
Date Tested: 03/16/2021
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:
Additional Comments When Verified:
Sample No. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 8741
Finish Coating ASTM F2329 - Hot Dip
Product Markings W
Size .75 in
Bolt Length no data in
Measurement Average 3.22 mils

Test 4 of 5

DIME Test ID: 2021-02-19-26-4
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: 03/16/2021
Date Tested: 03/16/2021
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:
Additional Comments When Verified:
Sample No. 1D
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 8741
Finish Coating ASTM F2329 - Hot Dip
Product Markings W
Size .75 in
Bolt Length no data in
Measurement Average 4.39 mils

Test 5 of 5

DIME Test ID: 2021-02-19-26-5
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: 03/16/2021
Date Tested: 03/16/2021
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:
Additional Comments When Verified:
Sample No. 1E
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 8741
Finish Coating ASTM F2329 - Hot Dip
Product Markings W
Size .75 in
Bolt Length no data in
Measurement Average 3.63 mils

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.