Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215421 DEA: 042K9504 EFIS: 0417000057
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-580-14.4/14.4
Work Description: CONSTRUCT MATERIAL TESTING LABORATORY BUILDING.
Location Description: ALAMEDA COUNTY IN LIVERMORE AT 2201 KITTY HAWK ROAD
Contractor Name: Walsh Construction Company II, LLC (Walsh) - Dominic Fung
Contractor Address: 1390 Willow Pass Road Suite 950, Concord, CA 94520
Resident Engineer: Amir-Fardin Sadeghi-Nedjad Structure Rep.: John Parecadan
DIME Sample ID: 2023-06-26-5
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: 06/26/2023
Date that the sample was received by the laboratory/organization performing the testing: 06/27/2023
The quantity of what the sample constitutes: 100 pieces
A brief description of the sample: 7/8” x 19” astm F1554 Rg 36 uncoated
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Lancaster and burns
Rocap Number(s): Na
Heat Number(s): 120104606761
Nut Mfg. Lot Number(s): Na
Washer Mfg. Lot Number(s): Na
Bolt Specification: Astm f1554 Gr36
Bolt Length(s): 19”
Nut Specification: Na
Washer Specification: Na
Finish: Uncoated
Diameter/Size: 7/8”
Bolt Mfg. Lot Number: 2302224-48a
Rocap Test Requirement(s): Na
Lubricant Requirements(s): No
DIME Test ID: 2023-06-26-5-1
Test Method: ASME B1.2-83r17: (Pitch Diameter) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Pitch Diameter)
Verified Date: 07/06/2023
Date Tested: 07/06/2023
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:
Test Result Compliance:
Additional Comments When Verified:
Sample No.
|
1A
|
Rocap Number
|
no data
|
Heat Number(s)
|
120104606761
|
Mfg. Lot Number
|
no data
|
Finish Coating
|
Plain
|
Product Markings
|
BLUE
|
Size
|
.875 in
|
Bolt Length
|
19 in
|
Pitch Diameter
|
0.792 in
|
Pitch Diameter 2nd
|
0.792 in
|
DIME Test ID: 2023-06-26-5-2
Test Method: ASME B1.2-83r17: (Pitch Diameter) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Pitch Diameter)
Verified Date: 07/06/2023
Date Tested: 07/06/2023
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:
Test Result Compliance:
Additional Comments When Verified:
Sample No.
|
1B
|
Rocap Number
|
no data
|
Heat Number(s)
|
120104606761
|
Mfg. Lot Number
|
no data
|
Finish Coating
|
Plain
|
Product Markings
|
BLUE
|
Size
|
.875 in
|
Bolt Length
|
19 in
|
Pitch Diameter
|
0.792 in
|
Pitch Diameter 2nd
|
0.792 in
|