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: 2023-08-04-22
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Department Acceptance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 08/04/2023
Date that the sample was received by the laboratory/organization performing the testing: 08/08/2023
The quantity of what the sample constitutes: 20
A brief description of the sample: 5/8 A194 2H Nuts
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: LB Construction
Rocap Number(s):
Heat Number(s): 75067329
Nut Mfg. Lot Number(s): 26506-75067329
Washer Mfg. Lot Number(s):
Bolt Specification: na
Bolt Length(s):
Nut Specification: A194 2H
Washer Specification: na
Finish: Black
Diameter/Size: 5/8"
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):
DIME Test ID: 2023-08-04-22-1
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: 08/10/2023
Date Tested: 08/10/2023
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: Proof Load
Test Result Compliance:
Additional Comments When Verified:
Number of Samples
|
1
|
Sample | Bolt Mfg. Lot Number | Size (in) | Peak Load (lbf) | Peak Load (kN) | Comments | Tested By | 1A | | | 39649 | | Proof Load | |
| |
UTM
|
400kip
|
Temperature
|
72 f
|
DIME Test ID: 2023-08-04-22-2
Test Method: ASME B1.2-83r17: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 08/10/2023
Date Tested: 08/10/2023
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
|
26506-75067329
|
Finish Coating
|
Plain
|
Product Markings
|
U 2H
|
Size
|
0.625 in
|
Gage Type
|
Pass
|
DIME Test ID: 2023-08-04-22-3
Test Method: ASME B1.2-83r17: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 08/10/2023
Date Tested: 08/10/2023
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
|
26506-75067329
|
Finish Coating
|
Plain
|
Product Markings
|
U 2H
|
Size
|
0.625 in
|
Gage Type
|
Pass
|