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Testing Report for 2021-01-21-8-7

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

Project Information

DEA: 041J5694
EFIS: 0419000313
Project ID: 214601
QA Service Level: 1
DIST-CO-RTE-PM: 04-SM-101-0.0/21.8
Work Description: Barrier modifications, overhead signs, freeway lighting and electronic toll system components
Location Description: SANTA CLARA AND SAN MATEO COUNTIES FROM 0.3 MILE NORTH OF SAN ANTONIO ROAD TO 0.3 MILE SOUTH OF GRAND AVENUE INTERCHANGE
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Douglas Inori
Structure Rep.: Tyler Pinell

Sample Information

DIME Sample ID: 2021-01-21-8
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: 1/21/2021
Date that the sample was received by the laboratory/organization performing the testing: 1/27/2021
The quantity of what the sample constitutes: 105 fastener assemblies
A brief description of the sample: HS Bolt Assembly
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name: Overhead Sign Structures
The fabricator/manufacturer/facility name: Structural and Steel Products

Material Information

Rocap Number(s): TT0135398
Heat Number(s): 10176580
Nut Mfg. Lot Number(s): L035T1
Washer Mfg. Lot Number(s): D9266
Bolt Specification: ASTM F3125, Gr A325
Bolt Length(s): 2-3/4"
Nut Specification: ASTM F563 Gr DH
Washer Specification: ASTM F436
Finish: MG B695, Class 55
Diameter/Size: 1/2"
Bolt Mfg. Lot Number: M4163
Rocap Test Requirement(s): Yes
Lubricant Requirements(s): Yes

Test Information

DIME Test ID: 2021-01-21-8-7
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Date Tested: 2/4/2021
Verified Date: 2/4/2021
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:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Sample No.: 1B
Rocap Number: no data
Heat Number(s): no data
Mfg. Lot Number: L035T1
Finish Coating: ASTM B695 - Mech Galv
Product Markings: DH USA LE
Size: .5 in
Gage Type: NA