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Sample Record for 2021-10-28-1

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

Project Information

Project ID: 214579 DEA: 010B0904 EFIS: 0100020444 QA Service Level: 1
DIST-CO-RTE-PM: 01-DN-101-8.2/8.7
Work Description: BRIDGE REPLACEMENT
Location Description: DEL NORTE COUNTY NEAR KLAMATH AT PANTHER CREEK BRIDGE AND AT HUNTER CREEK BRIDGE
Contractor Name: Golden State Bridge, Inc
Contractor Address: 3701 Mallard Dr., Benicia, CA 94510
Resident Engineer: Ryan Dunne Structure Rep.: Bryan Keene

Sample Information

DIME Sample ID: 2021-10-28-1
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7263
Type of Sample: Verification
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 10/28/2021
Date that the sample was received by the laboratory/organization performing the testing: 11/01/2021
The quantity of what the sample constitutes: 5 nuts
A brief description of the sample: ASTM A563
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Wecall Inc

Material Information

Rocap Number(s):
Heat Number(s): 10090546823
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s):
Bolt Specification: None
Bolt Length(s):
Nut Specification: ASTM A563
Washer Specification: None
Finish:
Diameter/Size:
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Results

Test 1 of 3

DIME Test ID: 2021-10-28-1-1
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 11/08/2021
Date Tested: 11/05/2021
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 6456
Finish Coating ASTM F2329 - Hot Dip
Product Markings NONE
Size .75 in
Gage Type Pass

Test 2 of 3

DIME Test ID: 2021-10-28-1-2
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: 11/08/2021
Date Tested: 11/05/2021
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 6456
Finish Coating ASTM F2329 - Hot Dip
Product Markings NONE
Size .75 in
Bolt Length no data in
Measurement Average 4.14 mils

Test 3 of 3

DIME Test ID: 2021-10-28-1-3
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 11/08/2021
Date Tested: 11/05/2021
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 6456
Finish Coating ASTM F2329 - Hot Dip
Product Markings NONE
Size .75 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 28.31
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.