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Sample Record for 2023-09-19-9

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

Project Information

Project ID: 994486 DEA: 051Q0804 EFIS: 0522000148 QA Service Level: 1
DIST-CO-RTE-PM: 05-SCR,SCR/SCR-9,1-17.41/17.5
Work Description: Repair of viaduct barrier wall and replace CIDH piles. Holiday Lane Viaduct Slipout. State Route 9 at PM SCR-09-8.4 Jay's Slide, and SR 236 (SCR-236-16.87)
Location Description: Santa Cruz County. State Route 9 at PM SCR-09-8.4 and SR 236 (SCR-236-16.87)
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 580 West Beach St, Watsonville, CA 95076
Resident Engineer: Ian Nguyen Structure Rep.: Stephen Pozzo

Sample Information

DIME Sample ID: 2023-09-19-9
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 09/19/2023
Date that the sample was received by the laboratory/organization performing the testing: 09/22/2023
The quantity of what the sample constitutes: 394
A brief description of the sample: 1-1/4" F436 Flat Washer HDG
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Universal Industrial Sales Inc

Material Information

Rocap Number(s): na
Heat Number(s): 223903
Nut Mfg. Lot Number(s): na
Washer Mfg. Lot Number(s): 223903
Bolt Specification: na
Bolt Length(s): na
Nut Specification: na
Washer Specification: F436
Finish: HDG
Diameter/Size: 1-1/4"
Bolt Mfg. Lot Number: na
Rocap Test Requirement(s): na
Lubricant Requirements(s): na
Test results on following page(s): 6

Test Results

Test 1 of 6

DIME Test ID: 2023-09-19-9-1
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: 09/22/2023
Date Tested: 09/22/2023
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 223903
Finish Coating ASTM F2329 - Hot Dip
Product Markings WS
Size 1.25 in
Bolt Length no data in
Measurement Average 2.6 mils

Test 2 of 6

DIME Test ID: 2023-09-19-9-2
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: 09/22/2023
Date Tested: 09/22/2023
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 223903
Finish Coating ASTM F2329 - Hot Dip
Product Markings WS
Size 1.25 in
Bolt Length no data in
Measurement Average 3.45 mils

Test 3 of 6

DIME Test ID: 2023-09-19-9-3
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: 09/22/2023
Date Tested: 09/22/2023
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. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 223903
Finish Coating ASTM F2329 - Hot Dip
Product Markings WS
Size 1.25 in
Bolt Length no data in
Measurement Average 2.63 mils

Test 4 of 6

DIME Test ID: 2023-09-19-9-4
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 09/22/2023
Date Tested: 09/22/2023
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 223903
Finish Coating ASTM F2329 - Hot Dip
Product Markings WS
Size 1.25 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 35.45
Spacing Ok

Test 5 of 6

DIME Test ID: 2023-09-19-9-5
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 09/22/2023
Date Tested: 09/22/2023
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 223903
Finish Coating ASTM F2329 - Hot Dip
Product Markings WS
Size 1.25 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 36.2
Spacing Ok

Test 6 of 6

DIME Test ID: 2023-09-19-9-6
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 09/22/2023
Date Tested: 09/22/2023
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. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 223903
Finish Coating ASTM F2329 - Hot Dip
Product Markings WS
Size 1.25 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 35.65
Spacing Ok