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Sample Record for 2023-05-16-53

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

Project Information

Project ID: 214830 DEA: 043G6304 EFIS: 0412000409 QA Service Level: 1
DIST-CO-RTE-PM: 04-SCL-4-SCl-9 -4.75/4.9
Work Description: Saratoga Creek Bridge Rehabilitation Project
Location Description: San Jose - Saratoga Creek
Contractor Name: Myers and Sons
Contractor Address: 4600 NORTHGATE BLVD, STE 100, SACRAMENTO, CA 95834
Resident Engineer: Arif Khan Structure Rep.: OANH BUI

Sample Information

DIME Sample ID: 2023-05-16-53
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (530) 329-6527
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 05/16/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/17/2023
The quantity of what the sample constitutes: NA
A brief description of the sample: Lock Washer
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: NA

Material Information

Rocap Number(s):
Heat Number(s): V032011747
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s): 21060423
Bolt Specification: NA
Bolt Length(s):
Nut Specification: NA
Washer Specification: NA Lock Washer
Finish: HDG
Diameter/Size: 7/8
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2023-05-16-53-1
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: 06/19/2023
Date Tested: 05/23/2023
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 21060423
Finish Coating ASTM F2329 - Hot Dip
Product Markings no data
Size 0.875 in
Bolt Length no data in
Measurement Average 6.61 mils

Test 2 of 2

DIME Test ID: 2023-05-16-53-2
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: 06/19/2023
Date Tested: 05/23/2023
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. 1B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 21060423
Finish Coating ASTM F2329 - Hot Dip
Product Markings no data
Size 0.875 in
Bolt Length no data in
Measurement Average 9.72 mils