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Sample Record for 2022-01-11-6

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

Project Information

Project ID: 88888 DEA: SMTL-STOCK EFIS: SMTL-STOCK QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for SMTL stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2022-01-11-6
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: 01/11/2022
Date that the sample was received by the laboratory/organization performing the testing: 01/14/2022
The quantity of what the sample constitutes: 585
A brief description of the sample: 2" Anchor Bolt Nuts
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): 75083703
Nut Mfg. Lot Number(s): DEET
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"
Bolt Mfg. Lot Number: na
Rocap Test Requirement(s): na
Lubricant Requirements(s): None
Test results on following page(s): 8

Test Results

Test 1 of 8

DIME Test ID: 2022-01-11-6-1
Test Method: ASME B1.2-83r17: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 02/01/2022
Date Tested: 01/31/2022
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 DEET
Finish Coating Plain
Product Markings DH D/N 2H
Size 2 in
Gage Type Pass

Test 2 of 8

DIME Test ID: 2022-01-11-6-2
Test Method: ASME B1.2-83r17: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 02/01/2022
Date Tested: 01/31/2022
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 DEET
Finish Coating Plain
Product Markings DH D/N 2H
Size 2 in
Gage Type Pass

Test 3 of 8

DIME Test ID: 2022-01-11-6-3
Test Method: ASME B1.2-83r17: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 02/01/2022
Date Tested: 01/31/2022
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 DEET
Finish Coating Plain
Product Markings DH D/N 2H
Size 2 in
Gage Type Pass

Test 4 of 8

DIME Test ID: 2022-01-11-6-4
Test Method: ASME B1.2-83r17: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 02/01/2022
Date Tested: 01/31/2022
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 DEET
Finish Coating Plain
Product Markings DH D/N 2H
Size 2 in
Gage Type Pass

Test 5 of 8

DIME Test ID: 2022-01-11-6-5
Test Method: ASME B1.2-83r17: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 02/01/2022
Date Tested: 01/31/2022
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 DEET
Finish Coating Plain
Product Markings DH D/N 2H
Size 2 in
Gage Type Pass

Test 6 of 8

DIME Test ID: 2022-01-11-6-6
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 02/01/2022
Date Tested: 01/31/2022
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 DEET
Finish Coating Plain
Product Markings DH D/N 2H
Size 2 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 30.02
Spacing Ok

Test 7 of 8

DIME Test ID: 2022-01-11-6-7
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 02/01/2022
Date Tested: 01/31/2022
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 DEET
Finish Coating Plain
Product Markings DH D/N 2H
Size 2 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 30.8
Spacing Ok

Test 8 of 8

DIME Test ID: 2022-01-11-6-8
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 02/01/2022
Date Tested: 01/31/2022
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 DEET
Finish Coating Plain
Product Markings DH D/N 2H
Size 2 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 30.57
Spacing Ok