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Sample Record for 2021-09-09-1

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Project Information

Project ID: 212112 DEA: 080C2514 EFIS: 0816000076 COOP: 081645 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-10-0.0/13.2
Work Description: Design-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes
Location Description: LA/SBD County Line to PM 13.2 near I-15
Contractor Name: Lane-Security Paving Joint Venture
Contractor Address: 3450 Centre Lake Drive, 1st Floor, Ontario, CA 91761
Resident Engineer: Jose Corona Structure Rep.: Luis Negrete

Sample Information

DIME Sample ID: 2021-09-09-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 09/09/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/13/2021
The quantity of what the sample constitutes: 34
A brief description of the sample: F1554 Grade 55 HDG Anchor Bolts
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue Circle Corp

Material Information

Rocap Number(s):
Heat Number(s): 1201034503
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s):
Bolt Specification: ASTM F1554
Bolt Length(s):
Nut Specification: N/A
Washer Specification: N/A
Finish: ASTM A153 - Hot Dip
Diameter/Size: 1-1/4"
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):
Test results on following page(s): 4

Test Results

Test 1 of 4

DIME Test ID: 2021-09-09-1-1
Test Method: ASTM A370-15: Standard Test Methods and Definitions for Mechanical Testing of Steel Products (Tensile - Round Sample)
Verified Date: 09/15/2021
Date Tested: 09/14/2021
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:
Number of Samples 1
SampleHeat NumberDiameter (in)Area (sqin)Stress at Offset (psi)Tensile Strength (psi)Elongation in 4 x d (%)Tested By
112010345030.4990.196614018682028.7spaine
UTM 67kip
Temperature 72 f

Test 2 of 4

DIME Test ID: 2021-09-09-1-2
Test Method: ASTM A370-15: Standard Test Methods and Definitions for Mechanical Testing of Steel Products (Tensile - Round Sample)
Verified Date: 09/15/2021
Date Tested: 09/14/2021
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:
Number of Samples 1
SampleHeat NumberDiameter (in)Area (sqin)Stress at Offset (psi)Tensile Strength (psi)Elongation in 4 x d (%)Tested By
212010345030.50.196629328658329.6spaine
UTM 67kip
Temperature 72 f

Test 3 of 4

DIME Test ID: 2021-09-09-1-3
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Verified Date: 09/15/2021
Date Tested: 09/15/2021
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) 1201034503
Mfg. Lot Number no data
Finish Coating ASTM A153 - Hot Dip
Product Markings YELLOW
Size 1.25 in
Bolt Length 18 in
Gage Type Pass

Test 4 of 4

DIME Test ID: 2021-09-09-1-4
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: 09/15/2021
Date Tested: 09/15/2021
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) 1201034503
Mfg. Lot Number no data
Finish Coating ASTM A153 - Hot Dip
Product Markings YELLOW
Size 1.25 in
Bolt Length 18 in
Measurement Average 4.17 mils