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Sample Record for 2021-06-10-9

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

Project Information

Project ID: 215032 DEA: 030H5204 EFIS: 0315000202 QA Service Level: 1
DIST-CO-RTE-PM: 03-ED-50-0.0/80.4
Work Description: INSTALL CMS, CAMERA SYSTEMS AND TMS ELEMENTS.
Location Description: EL DORADO COUNTY AT VARIOUS LOCATIONS FROM THE SACRAMENTO COUNTY LINE TO CALIFORNIA/NEVADA STATE LINE
Contractor Name: TIM PAXIN'S PACIFIC EXCAVATION INC
Contractor Address: 9796 KENT STREET, ELK GROVE CA 95624
Resident Engineer: Juanah Koker Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-06-10-9
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: 21
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): 5/21/21A
Heat Number(s): 101590
Nut Mfg. Lot Number(s): N/A
Washer Mfg. Lot Number(s): 12880
Bolt Specification: N/A
Bolt Length(s):
Nut Specification: N/A
Washer Specification: F436
Finish: Galvanized
Diameter/Size: 3/4-10
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Results

Test 1 of 2

DIME Test ID: 2021-06-10-9-1
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: 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 12880
Finish Coating ASTM F2329 - Hot Dip
Product Markings WS
Size .75 in
Bolt Length no data in
Measurement Average 2.9 mils

Test 2 of 2

DIME Test ID: 2021-06-10-9-2
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:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 12880
Finish Coating ASTM F2329 - Hot Dip
Product Markings WS
Size .75 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 35.35
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.