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Sample Record for 2021-03-01-15

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Project Information

Project ID: 213653 DEA: 044G8204 EFIS: 0413000049 QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN-101-10.6/10.8
Work Description: REPLACE SAN RAFAEL HARBOR BRIDGE (ABC)
Location Description: MARIN COUTY, IN SAN RAFAEL, FROM ROUTE 101 NORTHBOUND OFF-RAMP TO 2ND STREET
Contractor Name: Gordon N. Ball
Contractor Address: 333 Camille Ave., Alamo, CA 94507
Resident Engineer: Dawit Habteselassie Structure Rep.: Long N Ly

Sample Information

DIME Sample ID: 2021-03-01-15
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: 03/01/2021
Date that the sample was received by the laboratory/organization performing the testing: 03/11/2021
The quantity of what the sample constitutes: 75 assemblies
A brief description of the sample: 1-7/8” x 8-1/8” panel pin
From where was the sample collected: Fabricator
Laboratory sample identification: AB051
Structure unique identifier:
Structure name: Temporary Modular Bridge
The fabricator/manufacturer/facility name: Acrow Bridge

Material Information

Rocap Number(s):
Heat Number(s): AB051
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s):
Bolt Specification: ASTM 193 B7
Bolt Length(s): 8-1/8”
Nut Specification: NA
Washer Specification: NA
Finish: HDG ASTM A153
Diameter/Size: 1-7/8"
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: 2021-03-01-15-1
Test Method: ASTM A370-15: Standard Test Methods and Definitions for Mechanical Testing of Steel Products (Tensile - Round Sample)
Verified Date: 03/25/2021
Date Tested: 03/17/2021
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:
Number of Samples 1
SampleHeat NumberDiameter (in)Area (sqin)Stress at Offset (psi)Tensile Strength (psi)Elongation in 4 x d (%)Tested By
1AB0510.4910.18912757814842416.9fsaylor
UTM 67kip
Temperature 72 f

Test 2 of 2

DIME Test ID: 2021-03-01-15-2
Test Method: ASTM A370-15: Standard Test Methods and Definitions for Mechanical Testing of Steel Products (Tensile - Round Sample)
Verified Date: 03/25/2021
Date Tested: 03/17/2021
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:
Number of Samples 1
SampleHeat NumberDiameter (in)Area (sqin)Stress at Offset (psi)Tensile Strength (psi)Elongation in 4 x d (%)Tested By
2AB0510.4930.19112625914201617.6fsaylor
UTM 67kip
Temperature 72 f