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Sample Record for 2021-05-05-9

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

Project Information

Project ID: 213856 DEA: 112888U4 EFIS: 1118000199 QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-11,125,905-Various
Work Description: CONSTRUCT FREEWAY TO FREEWAY CONNECTORS AND 4-LANE HIGHWAY FACILITY
Location Description: SAN DIEGO COUNTY AT VARIOUS LOCATIONS
Contractor Name: Skanska USA Civil West CA
Contractor Address: 1995 Agua Mansa Road, Riverside, CA 92509
Resident Engineer: Carlos Covarrubias Structure Rep.: Wade Durant

Sample Information

DIME Sample ID: 2021-05-05-9
TL Number from the TL Form: na
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: 05/05/2021
Date that the sample was received by the laboratory/organization performing the testing: 05/05/2021
The quantity of what the sample constitutes: 1080
A brief description of the sample: Anchor Bolt Hardware
From where was the sample collected: Fabricator
Laboratory sample identification: na
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Universal Industrial Sales Inc

Material Information

Rocap Number(s): na
Heat Number(s): 202254
Nut Mfg. Lot Number(s): na
Washer Mfg. Lot Number(s): 12199
Bolt Specification: na
Bolt Length(s): na
Nut Specification: na
Washer Specification: F336
Finish: HDG
Diameter/Size: 2-1/4"
Bolt Mfg. Lot Number: na
Rocap Test Requirement(s): na
Lubricant Requirements(s): na
Test results on following page(s): 8

Test Results

Test 1 of 8

DIME Test ID: 2021-05-05-9-1
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: 05/11/2021
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:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 12199
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size 2.25 in
Bolt Length no data in
Measurement Average 2.21 mils

Test 2 of 8

DIME Test ID: 2021-05-05-9-2
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: 05/11/2021
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:
Sample No. 1B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 12199
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size 2.25 in
Bolt Length no data in
Measurement Average 5.29 mils

Test 3 of 8

DIME Test ID: 2021-05-05-9-3
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: 05/20/2021
Date Tested: 05/11/2021
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:
Sample No. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 12199
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size 2.25 in
Bolt Length no data in
Measurement Average 3.93 mils

Test 4 of 8

DIME Test ID: 2021-05-05-9-4
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: 05/20/2021
Date Tested: 05/11/2021
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:
Sample No. 1D
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 12199
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size 2.25 in
Bolt Length no data in
Measurement Average 2.73 mils

Test 5 of 8

DIME Test ID: 2021-05-05-9-5
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: 05/11/2021
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:
Sample No. 1E
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 12199
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size 2.25 in
Bolt Length no data in
Measurement Average 2.89 mils

Test 6 of 8

DIME Test ID: 2021-05-05-9-6
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 05/20/2021
Date Tested: 05/11/2021
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:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 12199
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size 2.25 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 39.45
Spacing Ok

Test 7 of 8

DIME Test ID: 2021-05-05-9-7
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 05/20/2021
Date Tested: 05/11/2021
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:
Sample No. 1B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 12199
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size 2.25 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 38.75
Spacing Ok

Test 8 of 8

DIME Test ID: 2021-05-05-9-8
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 05/20/2021
Date Tested: 05/11/2021
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:
Sample No. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 12199
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size 2.25 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 39.35
Spacing Ok