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Sample Record for 2021-07-08-13

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

Project Information

Project ID: 214922 DEA: 100X3104 EFIS: 1013000265 QA Service Level: 1
DIST-CO-RTE-PM: 10-SJ-99-16.8/17.6
Work Description: REPLACE BRIDGE.
Location Description: SAN JOAQUIN COUNTY IN STOCKTON FROM 0.4 MILE SOUTH TO 0.4 MILE NORTH OF FARMINGTON ROAD OVERCROSSING
Contractor Name: BRIDGEWAY CIVIL CONSTRUCTORS, INC.
Contractor Address: 3333 Vaca Valley Parkway, Suite 200, Vacaville, CA 95219
Resident Engineer: David Abledu Structure Rep.: Daniel Laureno

Sample Information

DIME Sample ID: 2021-07-08-13
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: 07/08/2021
Date that the sample was received by the laboratory/organization performing the testing: 07/08/2021
The quantity of what the sample constitutes: 2700
A brief description of the sample: A563-DH Heavy Hex Nut Plain
From where was the sample collected: Fabricator
Laboratory sample identification: na
Structure unique identifier:
Structure name: na
The fabricator/manufacturer/facility name: Universal Industrial Sales Inc

Material Information

Rocap Number(s): na
Heat Number(s): 201548
Nut Mfg. Lot Number(s): DECN
Washer Mfg. Lot Number(s): na
Bolt Specification: na
Bolt Length(s): na
Nut Specification: A563-DH
Washer Specification: na
Finish: Plain
Diameter/Size: 2-1/2"
Bolt Mfg. Lot Number: na
Rocap Test Requirement(s): na
Lubricant Requirements(s): no
Test results on following page(s): 8

Test Results

Test 1 of 8

DIME Test ID: 2021-07-08-13-1
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 07/21/2021
Date Tested: 07/20/2021
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 DECN
Finish Coating Plain
Product Markings DH D/N 2H
Size 2.5 in
Gage Type Pass

Test 2 of 8

DIME Test ID: 2021-07-08-13-2
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 07/21/2021
Date Tested: 07/20/2021
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 DECN
Finish Coating Plain
Product Markings DH D/N 2H
Size 2.5 in
Gage Type Pass

Test 3 of 8

DIME Test ID: 2021-07-08-13-3
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 07/21/2021
Date Tested: 07/20/2021
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 DECN
Finish Coating Plain
Product Markings DH D/N 2H
Size 2.5 in
Gage Type Pass

Test 4 of 8

DIME Test ID: 2021-07-08-13-4
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 07/21/2021
Date Tested: 07/20/2021
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 DECN
Finish Coating Plain
Product Markings DH D/N 2H
Size 2.5 in
Gage Type Pass

Test 5 of 8

DIME Test ID: 2021-07-08-13-5
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 07/21/2021
Date Tested: 07/20/2021
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 DECN
Finish Coating Plain
Product Markings DH D/N 2H
Size 2.5 in
Gage Type Pass

Test 6 of 8

DIME Test ID: 2021-07-08-13-6
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 07/21/2021
Date Tested: 07/20/2021
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 DECN
Finish Coating Plain
Product Markings DH D/N 2H
Size 2.5 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 28.88
Spacing Ok

Test 7 of 8

DIME Test ID: 2021-07-08-13-7
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 07/21/2021
Date Tested: 07/20/2021
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 DECN
Finish Coating Plain
Product Markings DH D/N 2H
Size 2.5 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 27.03
Spacing Ok

Test 8 of 8

DIME Test ID: 2021-07-08-13-8
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 07/21/2021
Date Tested: 07/20/2021
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 DECN
Finish Coating Plain
Product Markings DH D/N 2H
Size 2.5 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 26.65
Spacing Ok