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Testing Report for 2021-09-09-1-3

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

Project Information

DEA: 080C2514
EFIS: 0816000076
Project ID: 212112
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-10-0.0/13.2
Work Description: Design-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes
Location Description: LA/SBD County Line to PM 13.2 near I-15
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Matt Antonelli
Structure Rep.: Faisal Zahlout

Sample Information

DIME Sample ID: 2021-09-09-1
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: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 9/9/2021
Date that the sample was received by the laboratory/organization performing the testing: 9/13/2021
The quantity of what the sample constitutes: 34
A brief description of the sample: F1554 Grade 55 HDG Anchor Bolts
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue Circle Corp

Material Information

Rocap Number(s):
Heat Number(s): 1201034503
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s):
Bolt Specification: ASTM F1554
Bolt Length(s):
Nut Specification: N/A
Washer Specification: N/A
Finish: ASTM A153 - Hot Dip
Diameter/Size: 1-1/4"
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2021-09-09-1-3
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Date Tested: 9/15/2021
Verified Date: 9/15/2021
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): 1201034503
Mfg. Lot Number: no data
Finish Coating: ASTM A153 - Hot Dip
Product Markings: YELLOW
Size: 1.25 in
Bolt Length: 18 in
Gage Type: Pass