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Testing Report for 2021-04-22-1-2

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

Project Information

DEA: 010B0904
EFIS: 0100020444
Project ID: 214579
QA Service Level: 1
DIST-CO-RTE-PM: 01-DN-101-8.2/8.7
Work Description: BRIDGE REPLACEMENT
Location Description: DEL NORTE COUNTY NEAR KLAMATH AT PANTHER CREEK BRIDGE AND AT HUNTER CREEK BRIDGE
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Ryan Dunne
Structure Rep.: Bryan Keene

Sample Information

DIME Sample ID: 2021-04-22-1
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7263
Type of Sample: Acceptance
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: 5/11/2021
The quantity of what the sample constitutes: 120
A brief description of the sample: 1 1/8" A563 Gr DH Nuts
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Thompson Metal Fab

Material Information

Rocap Number(s):
Heat Number(s): 100897555
Nut Mfg. Lot Number(s): 432156A
Washer Mfg. Lot Number(s):
Bolt Specification: N/A
Bolt Length(s):
Nut Specification: A563
Washer Specification: N/A
Finish: HDG
Diameter/Size: 1.125
Bolt Mfg. Lot Number: N/A
Rocap Test Requirement(s): No
Lubricant Requirements(s): Yes

Test Information

DIME Test ID: 2021-04-22-1-2
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Date Tested: 5/12/2021
Verified Date: 5/20/2021
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.: 1A
Rocap Number: no data
Heat Number(s): no data
Mfg. Lot Number: 432156A
Finish Coating: ASTM F2329 - Hot Dip
Product Markings: DH N
Size: 1.125 in
Gage Type: NA