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Testing Report for 2021-06-30-28-5

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

Project Information

DEA: 120K0234
EFIS: 1214000100
Project ID: 214951
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-5-17.1/18.9
Work Description: South County Improvement Project (Phase 3 - El Toro/Alicia) WIDEN FREEWAY AND BRIDGES, RECONSTRUCT BRIDGE AND WALLS.
Location Description: ORANGE COUNTY IN MISSION VIEJO, LAGUNA HILLS, LAGUNA WOODS AND LAKE FOREST FROM 0.4 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING TO 0.2 MILE NORTH OF EL TORO ROAD UNDERCROSSING
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Majid Javaherneshan
Structure Rep.: Young Kim

Sample Information

DIME Sample ID: 2021-06-30-28
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: 6/30/2021
Date that the sample was received by the laboratory/organization performing the testing: 7/12/2021
The quantity of what the sample constitutes: 86
A brief description of the sample: 2" x 50"
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Madden Bolt

Material Information

Rocap Number(s):
Heat Number(s): 58047362, 201699
Nut Mfg. Lot Number(s): DECZ
Washer Mfg. Lot Number(s): 1120-640
Bolt Specification: ASTM F1554
Bolt Length(s): 50"
Nut Specification: A194-2H/A563-DH
Washer Specification: F436
Finish: A153/A123 HDG
Diameter/Size: 2"
Bolt Mfg. Lot Number: 58047362
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2021-06-30-28-5
Test Method: ASME B1.2-83r01: (Pitch Diameter) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Pitch Diameter)
Date Tested: 7/13/2021
Verified Date: 7/13/2021
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.: 2C
Rocap Number: no data
Heat Number(s): 58047362
Mfg. Lot Number: no data
Finish Coating: Plain and A153 and F2329
Product Markings: no data
Size: 2 in
Bolt Length: 50 in
Pitch Diameter: 1.852 in
Pitch Diameter 2nd: no data