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Sample Record for 2022-11-18-3

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

Project Information

Project ID: 77777 DEA: CHEM-STOCK EFIS: CHEM-STOCK QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for Chem Lab 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: 2022-11-18-3
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: 11/18/2022
Date that the sample was received by the laboratory/organization performing the testing: 11/18/2022
The quantity of what the sample constitutes: 4
A brief description of the sample: 1.25" HEAVY HEX NUT
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: UIS Lindon UT

Material Information

Rocap Number(s):
Heat Number(s): 212403
Nut Mfg. Lot Number(s): 35100-212403
Washer Mfg. Lot Number(s): XXX
Bolt Specification: XXX
Bolt Length(s): XXX
Nut Specification: ASTM A563-DH/B695-55
Washer Specification: XXX
Finish: F148
Diameter/Size: 1.25"
Bolt Mfg. Lot Number: XXX
Rocap Test Requirement(s):
Lubricant Requirements(s):
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2022-11-18-3-1
Test Method: ASTM F606-21: Standard Test Methods for Determining the Mechanical Properties of Externally and Internally Threaded Fasteners, Washers, Direct Tension Indicators, and Rivets (Proof Load)
Verified Date: 12/06/2022
Date Tested: 11/30/2022
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: A563 Nut Proof
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleBolt Mfg. Lot NumberSize (in)Peak Load (lbf)Peak Load (kN)CommentsTested By
1A150492A563 Nut Proof
UTM 450kip
Temperature 72 f

Test 2 of 2

DIME Test ID: 2022-11-18-3-2
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: 12/06/2022
Date Tested: 11/30/2022
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 35100-212403
Finish Coating ASTM B695 - Mech Galv
Product Markings DH U
Size 1.25 in
Bolt Length no data in
Measurement Average 2.71 mils