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Sample Record for 2023-01-23-11

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

Project Information

Project ID: 215351 DEA: 101C8004 EFIS: 1015000037 QA Service Level: 1
DIST-CO-RTE-PM: 10-SJ-4-0/0
Work Description: REPLACE MECHANICAL AND ELECTRICAL MOVEABLE BRIDGE EQUIPMENT.
Location Description: SAN JOAQUIN COUNTY NEAR DISCOVERY BAY AT OLD RIVER SR4 BRIDGE
Contractor Name: CALIFORNIA ENGINEERING CONTRACTORS, INC.
Contractor Address: 20 Happy Valley Road, Pleasanton, CA 94566
Resident Engineer: Ranbir Bhullar Structure Rep.: Daniel Laureno

Sample Information

DIME Sample ID: 2023-01-23-11
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 01/23/2023
Date that the sample was received by the laboratory/organization performing the testing: 02/22/2023
The quantity of what the sample constitutes: 8
A brief description of the sample: 1 1/4" A563 DH Nut
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Nucor

Material Information

Rocap Number(s):
Heat Number(s): 8000014571
Nut Mfg. Lot Number(s): 471537A
Washer Mfg. Lot Number(s):
Bolt Specification: na
Bolt Length(s):
Nut Specification: A563
Washer Specification: na
Finish: HDG
Diameter/Size: 1.25"
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2023-01-23-11-1
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: 03/13/2023
Date Tested: 03/06/2023
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: Nut Proof Load
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleBolt Mfg. Lot NumberSize (in)Peak Load (lbf)Peak Load (kN)CommentsTested By
1A150383Nut Proof Load
UTM 450kip
Temperature 72 f

Test 2 of 3

DIME Test ID: 2023-01-23-11-2
Test Method: ASME B1.2-83r17: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 03/13/2023
Date Tested: 03/07/2023
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 471537A
Finish Coating ASTM F2329 - Hot Dip
Product Markings DH N
Size 1.25 in
Gage Type Pass

Test 3 of 3

DIME Test ID: 2023-01-23-11-3
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: 03/13/2023
Date Tested: 03/07/2023
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 471537A
Finish Coating ASTM F2329 - Hot Dip
Product Markings DH N
Size 1.25 in
Bolt Length no data in
Measurement Average 4.16 mils