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Sample Record for 2021-06-10-5

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

Project Information

Project ID: 215063 DEA: 032F5704 EFIS: 0300020615 QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-80-46.3/63.5
Work Description: Replace 4 Bridges (OC) on Highway 80 from Crystal Springs to Cisco Grove (Baxter, Drum Forebay)
Location Description:
Contractor Name: Walsh Construction Company II, LLC (Walsh)
Contractor Address: 1390 Willow Pass Road Suite 950, Concord, CA 94520
Resident Engineer: Tad Sampson Structure Rep.: Jimmer Ross

Sample Information

DIME Sample ID: 2021-06-10-5
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7263
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 06/10/2021
Date that the sample was received by the laboratory/organization performing the testing: 06/14/2021
The quantity of what the sample constitutes: 7
A brief description of the sample: High Strength Fastener Assemblies
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: SSP Fort Worth

Material Information

Rocap Number(s): 5/27/21A
Heat Number(s): DL20100004
Nut Mfg. Lot Number(s): 436795B
Washer Mfg. Lot Number(s):
Bolt Specification: N/A
Bolt Length(s):
Nut Specification: A563
Washer Specification: N/A
Finish: Galvanized
Diameter/Size: 3/4"-10
Bolt Mfg. Lot Number: N/A
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Results

Test 1 of 3

DIME Test ID: 2021-06-10-5-1
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: 06/16/2021
Date Tested: 06/15/2021
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: 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
1A436795B52609Nut Proof Loadspaine
UTM 450kip
Temperature 72 f

Test 2 of 3

DIME Test ID: 2021-06-10-5-2
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 06/16/2021
Date Tested: 06/16/2021
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:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 436795B
Finish Coating ASTM F2329 - Hot Dip
Product Markings DH N
Size .75 in
Gage Type Pass

Test 3 of 3

DIME Test ID: 2021-06-10-5-3
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: 06/16/2021
Date Tested: 06/16/2021
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:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 436795B
Finish Coating ASTM F2329 - Hot Dip
Product Markings DH N
Size .75 in
Bolt Length no data in
Measurement Average 3.37 mils

Tests Assigned to this Sample

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