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Testing Report for 2021-04-22-3-6

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

Project Information

DEA: No Project
EFIS:
Project ID: 0
QA Service Level:
DIST-CO-RTE-PM: ---
Work Description: Special project identifier for material not associated with a project
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-04-22-3
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Los Angeles Field Laboratory
Sample Organization Contact: (858) 285-5797
Type of Sample: Verification
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 4/22/2021
Date that the sample was received by the laboratory/organization performing the testing: 4/29/2021
The quantity of what the sample constitutes: 200
A brief description of the sample: Achor Bolt Assembly
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: A and M Nut and Bolt

Material Information

Rocap Number(s):
Heat Number(s):
Nut Mfg. Lot Number(s): 33576-201466
Washer Mfg. Lot Number(s): D9568
Bolt Specification: ASTM F1554 Grade 55
Bolt Length(s): 15" with 2" hook
Nut Specification: ASTM A194 HHN Grade 2H
Washer Specification: ASTM F436 M/G
Finish: HDG
Diameter/Size: 3/4"
Bolt Mfg. Lot Number: 3085620
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2021-04-22-3-6
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Date Tested: 4/29/2021
Verified Date: 5/6/2021
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: 33576-201466
Finish Coating: ASTM F2329 - Hot Dip
Product Markings: U 2H ZN
Size: .75 in
Gage Type: NA