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Sample Record for 2021-04-22-2

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

Project Information

Project ID: 214579 DEA: 010B0904 EFIS: 0100020444 QA Service Level: 1
DIST-CO-RTE-PM: 01-DN-101-8.2/8.7
Work Description: BRIDGE REPLACEMENT
Location Description: DEL NORTE COUNTY NEAR KLAMATH AT PANTHER CREEK BRIDGE AND AT HUNTER CREEK BRIDGE
Contractor Name: Golden State Bridge, Inc
Contractor Address: 3701 Mallard Dr., Benicia, CA 94510
Resident Engineer: Ryan Dunne Structure Rep.: Bryan Keene

Sample Information

DIME Sample ID: 2021-04-22-2
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7263
Type of Sample: Acceptance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 04/22/2021
Date that the sample was received by the laboratory/organization performing the testing: 04/26/2021
The quantity of what the sample constitutes: 120
A brief description of the sample: 1 1/8" F436 HDG Washer
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Thompson Metal Fab

Material Information

Rocap Number(s):
Heat Number(s): B53149
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s): 0220-393
Bolt Specification: N/A
Bolt Length(s):
Nut Specification: N/A
Washer Specification: F436
Finish: HDG
Diameter/Size: 1.125
Bolt Mfg. Lot Number: N/A
Rocap Test Requirement(s): No
Lubricant Requirements(s): No

Test Results

Test 1 of 5

DIME Test ID: 2021-04-22-2-1
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: 05/20/2021
Date Tested: 12/31/1969
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:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 0220-393
Finish Coating ASTM F2329 - Hot Dip
Product Markings F436 TSI
Size 1.125 in
Bolt Length no data in
Measurement Average 5.43 mils

Test 2 of 5

DIME Test ID: 2021-04-22-2-2
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: 05/20/2021
Date Tested: 12/31/1969
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:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 0220-393
Finish Coating ASTM F2329 - Hot Dip
Product Markings F436 TSI
Size 1.125 in
Bolt Length no data in
Measurement Average 3.95 mils

Test 3 of 5

DIME Test ID: 2021-04-22-2-3
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 05/20/2021
Date Tested: 12/31/1969
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:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 0220-393
Finish Coating ASTM F2329 - Hot Dip
Product Markings F436 TSI
Size 1.125 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 39.05
Spacing Ok

Test 4 of 5

DIME Test ID: 2021-04-22-2-4
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 05/20/2021
Date Tested: 12/31/1969
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:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 0220-393
Finish Coating ASTM F2329 - Hot Dip
Product Markings F436 TSI
Size 1.125 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 39.05
Spacing Ok

Test 5 of 5

DIME Test ID: 2021-04-22-2-5
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: 05/20/2021
Date Tested: 12/31/1969
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:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 0220-393
Finish Coating ASTM F2329 - Hot Dip
Product Markings F436 TSI
Size 1.125 in
Bolt Length no data in
Measurement Average 4.64 mils

Tests Assigned to this Sample

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