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Sample Record for 2023-09-20-11

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Project Information

Project ID: 993715 DEA: 010G1404 EFIS: 0116000129 QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-96,169-VAR
Work Description: HUM 96-169 5 Bridges Rail Upgrade (Do not include in project name: STRUCTURAL STEEL, CONCRETE BARRIER, POLYESTER CONCRETE OVERLAY)
Location Description: HUMBOLDT COUNTY ON ROUTES 96 AND 169 AT VARIOUS LOCATIONS (Bridge Nos. 04-0215, 04-0059, 04-0063, 04-0225, 04-0061)
Contractor Name: Steelhead Constructors JV
Contractor Address: P.O. Box 536, Palo Cedro, CA 96073
Resident Engineer: Efren Banuelos Structure Rep.: Laura Cangas

Sample Information

DIME Sample ID: 2023-09-20-11
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: 09/20/2023
Date that the sample was received by the laboratory/organization performing the testing: 09/25/2023
The quantity of what the sample constitutes: 405
A brief description of the sample: 1-8 x 4 1/2 bolt
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CK Johnson Industries

Material Information

Rocap Number(s):
Heat Number(s): 1000218911
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s):
Bolt Specification: ASTM F3125 grade A325
Bolt Length(s): 4.5
Nut Specification: NA
Washer Specification: NA
Finish: HDG
Diameter/Size: 1
Bolt Mfg. Lot Number: W000036916
Rocap Test Requirement(s):
Lubricant Requirements(s):
Test results on following page(s): 8

Test Results

Test 1 of 8

DIME Test ID: 2023-09-20-11-1
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 with Wedge)
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
Data has not been verified.

Test 2 of 8

DIME Test ID: 2023-09-20-11-2
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 with Wedge)
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
Data has not been verified.

Test 3 of 8

DIME Test ID: 2023-09-20-11-3
Test Method: ASME B1.2-83r17: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
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
Data has not been verified.

Test 4 of 8

DIME Test ID: 2023-09-20-11-4
Test Method: ASME B1.2-83r17: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
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
Data has not been verified.

Test 5 of 8

DIME Test ID: 2023-09-20-11-5
Test Method: ASME B1.2-83r17: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
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
Data has not been verified.

Test 6 of 8

DIME Test ID: 2023-09-20-11-6
Test Method: ASTM B499-09r21: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
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
Data has not been verified.

Test 7 of 8

DIME Test ID: 2023-09-20-11-7
Test Method: ASTM B499-09r21: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
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
Data has not been verified.

Test 8 of 8

DIME Test ID: 2023-09-20-11-8
Test Method: ASTM B499-09r21: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
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
Data has not been verified.