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Testing Report for 2021-06-02-13-6

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

Project Information

DEA: 042J8304
EFIS: 0415000006
Project ID: 215297
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-80,580,880-Var
Work Description: MODIFYING TRAFFIC MONITORING STATIONS. TMS REPLACE AND UPGRADE AT MAZE
Location Description: ALAMEDA COUNTY AT VARIOUS LOCATIONS
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Jason Trinh
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-06-02-13
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (916) 227-7253
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 6/2/2021
Date that the sample was received by the laboratory/organization performing the testing: 6/9/2021
The quantity of what the sample constitutes: 1
A brief description of the sample: F1554 Anchor Rods Nuts Washers
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Madden Bolt

Material Information

Rocap Number(s):
Heat Number(s): 3101507 190483 209034
Nut Mfg. Lot Number(s): XSF2
Washer Mfg. Lot Number(s): 6186
Bolt Specification: F1554 GR55
Bolt Length(s): 55"
Nut Specification: A563
Washer Specification: F436
Finish: HDG
Diameter/Size: 3"
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2021-06-02-13-6
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Date Tested: 6/10/2021
Verified Date: 7/14/2021
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.: 1C
Rocap Number: no data
Heat Number(s): no data
Mfg. Lot Number: XSF2
Finish Coating: ASTM F2329 - Hot Dip
Product Markings: DH D/N
Size: 3 in
Gage Type: Pass