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Sample Record for 2021-06-10-6

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.: Ross, Jimmer

Sample Information

DIME Sample ID: 2021-06-10-6
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): 201219
Nut Mfg. Lot Number(s): N/A
Washer Mfg. Lot Number(s): E0420
Bolt Specification: na
Bolt Length(s):
Nut Specification: N/A
Washer Specification: F436
Finish: Galvanized
Diameter/Size: 3/4"
Bolt Mfg. Lot Number: N/A
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Results

Test 1 of 2

DIME Test ID: 2021-06-10-6-1
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: 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:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number E0420
Finish Coating ASTM F2329 - Hot Dip
Product Markings F436 P
Size .75 in
Bolt Length no data in
Measurement Average 3.25 mils

Test 2 of 2

DIME Test ID: 2021-06-10-6-2
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
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:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number E0420
Finish Coating ASTM F2329 - Hot Dip
Product Markings F436 P
Size .75 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 38.25
Spacing Ok

Tests Assigned to this Sample

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