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Sample Record for 2022-02-03-26

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

Project Information

Project ID: 215371 DEA: 042W1204 EFIS: 0421000139 QA Service Level: 1
DIST-CO-RTE-PM: 04-CC,CC/MRN-580-6.9/7.8, 6.9, 7.8, 02, 5
Work Description: REPLACEMENT OF GUSSET PLATES AT VARIOUS LOCATIONS
Location Description: Richmond San Rafael Bridge
Contractor Name: FLATIRON WEST INC
Contractor Address: 2100 Goodyear Rd., Benicia, CA 94510
Resident Engineer: Behzad Halali Structure Rep.: William Sommer

Sample Information

DIME Sample ID: 2022-02-03-26
TL Number from the TL Form:
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: 02/03/2022
Date that the sample was received by the laboratory/organization performing the testing: 02/10/2022
The quantity of what the sample constitutes: 200
A brief description of the sample: ASTM F436 Washer
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name: RSRB
The fabricator/manufacturer/facility name: LeJeune Bolt Company

Material Information

Rocap Number(s):
Heat Number(s): 202539
Nut Mfg. Lot Number(s): n/a
Washer Mfg. Lot Number(s): 1120-636
Bolt Specification: n/a
Bolt Length(s): n/a
Nut Specification: n/a
Washer Specification: ASTM F436-1
Finish: Mech Galv
Diameter/Size: 1.0
Bolt Mfg. Lot Number: n/a
Rocap Test Requirement(s):
Lubricant Requirements(s):
Test results on following page(s): 5

Test Results

Test 1 of 5

DIME Test ID: 2022-02-03-26-1
Test Method: ASTM B499-09r21: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 02/23/2022
Date Tested: 02/22/2022
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 1120-636
Finish Coating ASTM B695 - Mech Galv
Product Markings F436 TSI
Size 1 in
Bolt Length no data in
Measurement Average 3.04 mils

Test 2 of 5

DIME Test ID: 2022-02-03-26-2
Test Method: ASTM B499-09r21: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 02/23/2022
Date Tested: 02/22/2022
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 1120-636
Finish Coating ASTM B695 - Mech Galv
Product Markings F436 TSI
Size 1 in
Bolt Length no data in
Measurement Average 5.1 mils

Test 3 of 5

DIME Test ID: 2022-02-03-26-3
Test Method: ASTM B499-09r21: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 02/23/2022
Date Tested: 02/22/2022
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 1120-636
Finish Coating ASTM B695 - Mech Galv
Product Markings F436 TSI
Size 1 in
Bolt Length no data in
Measurement Average 4.66 mils

Test 4 of 5

DIME Test ID: 2022-02-03-26-4
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 02/23/2022
Date Tested: 02/22/2022
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 1120-636
Finish Coating ASTM B695 - Mech Galv
Product Markings F436 TSI
Size 1 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 40.15
Spacing Ok

Test 5 of 5

DIME Test ID: 2022-02-03-26-5
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 02/23/2022
Date Tested: 02/22/2022
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 1120-636
Finish Coating ASTM B695 - Mech Galv
Product Markings F436 TSI
Size 1 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 40.2
Spacing Ok