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Sample Record for 2020-09-30-4

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

Project Information

Project ID: 214393 DEA: 101C6204 EFIS: 1015000001 QA Service Level: 1
DIST-CO-RTE-PM: 10-SJ,MPA,MER,SBT,SJ,SCL-5,88,99,104,120,etc.-15.69/29.56
Work Description: MODIFY ELECTRICAL SYSTEMS, INSTALL CAMERA SYSTEMS AND PLACE HMA.
Location Description: AMADOR, MARIPOSA, MERCED, SAN BENITO, SAN JOAQUIN, AND SANTA CLARA COUNTIES AT VARIOUS LOCATIONS
Contractor Name: PACIFIC INFRASTRUCTURE CONSTRUCTION, LLC
Contractor Address: 871 COTTING COURT STE A, VACAVILLE CA 95688
Resident Engineer: Obiadullah "Abdul" Rashid Structure Rep.: Vargas, Darwin

Sample Information

DIME Sample ID: 2020-09-30-4
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Bay Area Field Laboratory
Sample Organization Contact: (707) 649-5453
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 09/30/2020
Date that the sample was received by the laboratory/organization performing the testing: 10/02/2020
The quantity of what the sample constitutes: 596
A brief description of the sample: Anchor Bolt Hardware 7/8" x 17.5"
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): 201157
Nut Mfg. Lot Number(s): na
Washer Mfg. Lot Number(s): na
Bolt Specification: A449
Bolt Length(s): 17 1/2"
Nut Specification: na
Washer Specification: na
Finish: HDG
Diameter/Size: 7/8"
Bolt Mfg. Lot Number: 33171
Rocap Test Requirement(s): na
Lubricant Requirements(s): na

Test Results

Test Information 10 of 12

DIME Test ID: 2020-09-30-4-10
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 10/12/2020
Date Tested: 10/08/2020
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: paul.lukkarila@dot.ca.gov
Organization Phone: (916) 227-7253
General Comments for this Test:
Additional Comments When Verified:
Sample No. 1C
Rocap Number no data
Heat Number(s) 201157
Mfg. Lot Number 33171
Finish Coating ASTM F2329 - Hot Dip
Product Markings A449
Size .875 in
Bolt Length 17.5 in
Measurement Average 4.53 mils

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.