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Sample Record for 2021-09-27-17

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

Project Information

Project ID: 213411 DEA: 030H10U4 EFIS: 0317000246 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-5-9.7/24.9
Work Description:
Location Description: Construction on state highway in Sacramento County in and near Sacramento from 1.1 miles south of Elk Grove Boulevard to American River Viaduct
Contractor Name: NOR CAL PAVING TEICHERT/GRANITE
Contractor Address: 400 Sunrise Ave. Ste. #300, Roseville, CA 95661
Resident Engineer: Daniel Tecle Structure Rep.: Pha Tran

Sample Information

DIME Sample ID: 2021-09-27-17
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: 09/27/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/27/2021
The quantity of what the sample constitutes: 199
A brief description of the sample: 3/8" Flat washer
From where was the sample collected: Fabricator
Laboratory sample identification: na
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Universal Industrial Sales, Inc

Material Information

Rocap Number(s): na
Heat Number(s): 3198630
Nut Mfg. Lot Number(s): na
Washer Mfg. Lot Number(s): D9275
Bolt Specification: na
Bolt Length(s): na
Nut Specification: na
Washer Specification: F436
Finish: HDG
Diameter/Size: 3/8"
Bolt Mfg. Lot Number: na
Rocap Test Requirement(s):
Lubricant Requirements(s): na
Test results on following page(s): 6

Test Results

Test 1 of 6

DIME Test ID: 2021-09-27-17-1
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: 10/14/2021
Date Tested: 10/08/2021
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 D9275
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size .375 in
Bolt Length no data in
Measurement Average 3.22 mils

Test 2 of 6

DIME Test ID: 2021-09-27-17-2
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: 10/14/2021
Date Tested: 10/08/2021
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 D9275
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size .375 in
Bolt Length no data in
Measurement Average 2.59 mils

Test 3 of 6

DIME Test ID: 2021-09-27-17-3
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: 10/14/2021
Date Tested: 10/08/2021
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 D9275
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size .375 in
Bolt Length no data in
Measurement Average 2.68 mils

Test 4 of 6

DIME Test ID: 2021-09-27-17-4
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 10/14/2021
Date Tested: 10/08/2021
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 D9275
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size .375 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 38.75
Spacing Ok

Test 5 of 6

DIME Test ID: 2021-09-27-17-5
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 10/14/2021
Date Tested: 10/08/2021
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 D9275
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size .375 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 38.95
Spacing Ok

Test 6 of 6

DIME Test ID: 2021-09-27-17-6
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 10/14/2021
Date Tested: 10/08/2021
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 D9275
Finish Coating ASTM F2329 - Hot Dip
Product Markings P F436
Size .375 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 38.35
Spacing Ok