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Sample Record for 2021-09-22-18

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

Project Information

Project ID: 215371 DEA: 042W1204 EFIS: 0421000139 QA Service Level: 1
DIST-CO-RTE-PM: 04-CC,CC/MRN-580-6.9/7.8, 6.9, 7.8, 02, 5
Work Description: REPLACEMENT OF GUSSET PLATES AT VARIOUS LOCATIONS
Location Description: Richmond San Rafael Bridge
Contractor Name: FLATIRON WEST INC
Contractor Address: 2100 Goodyear Rd., Benicia, CA 94510
Resident Engineer: Behzad Halali Structure Rep.: William Sommer

Sample Information

DIME Sample ID: 2021-09-22-18
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 09/22/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/22/2021
The quantity of what the sample constitutes: 5857 nuts
A brief description of the sample: A563 nuts
From where was the sample collected: Other
Laboratory sample identification:
Structure unique identifier:
Structure name: RSRB
The fabricator/manufacturer/facility name: LeJeune Bolt Company

Material Information

Rocap Number(s):
Heat Number(s):
Nut Mfg. Lot Number(s): 30727-75075848
Washer Mfg. Lot Number(s): n/a
Bolt Specification: n/a
Bolt Length(s): n/a
Nut Specification: A563
Washer Specification: n/a
Finish: MG
Diameter/Size: 1.125
Bolt Mfg. Lot Number: n/a
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Results

Test 1 of 10

DIME Test ID: 2021-09-22-18-1
Test Method: ASTM F606-14a: Standard Test Methods for Determining the Mechanical Properties of Externally and Internally Threaded Fasteners, Washers, Direct Tension Indicators, and Rivets (Proof Load)
Verified Date: 09/29/2021
Date Tested: 09/28/2021
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test: A563
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleBolt Mfg. Lot NumberSize (in)Peak Load (lbf)Peak Load (kN)CommentsTested By
130727-75075848119104A563fsaylor
UTM 450kip
Temperature 72 f

Test 2 of 10

DIME Test ID: 2021-09-22-18-2
Test Method: ASTM F606-14a: Standard Test Methods for Determining the Mechanical Properties of Externally and Internally Threaded Fasteners, Washers, Direct Tension Indicators, and Rivets (Proof Load)
Verified Date: 09/29/2021
Date Tested: 09/28/2021
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test: A563
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleBolt Mfg. Lot NumberSize (in)Peak Load (lbf)Peak Load (kN)CommentsTested By
230727-75075848119082A563fsaylor
UTM 450kip
Temperature 72 f

Test 3 of 10

DIME Test ID: 2021-09-22-18-3
Test Method: ASTM F606-14a: Standard Test Methods for Determining the Mechanical Properties of Externally and Internally Threaded Fasteners, Washers, Direct Tension Indicators, and Rivets (Proof Load)
Verified Date: 09/29/2021
Date Tested: 09/28/2021
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test: A563
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleBolt Mfg. Lot NumberSize (in)Peak Load (lbf)Peak Load (kN)CommentsTested By
330727-75075848118714A563fsaylor
UTM 450kip
Temperature 72 f

Test 4 of 10

DIME Test ID: 2021-09-22-18-4
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 09/29/2021
Date Tested: 09/28/2021
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 30727-75075848
Finish Coating ASTM B695 - Mech Galv
Product Markings U DH
Size 1.125 in
Bolt Length no data in
Measurement Average 3.65 mils

Test 5 of 10

DIME Test ID: 2021-09-22-18-5
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 09/29/2021
Date Tested: 09/28/2021
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 30727-75075848
Finish Coating ASTM B695 - Mech Galv
Product Markings U DH
Size 1.125 in
Bolt Length no data in
Measurement Average 2.82 mils

Test 6 of 10

DIME Test ID: 2021-09-22-18-6
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 09/29/2021
Date Tested: 09/28/2021
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 30727-75075848
Finish Coating ASTM B695 - Mech Galv
Product Markings U DH
Size 1.125 in
Bolt Length no data in
Measurement Average 3.7 mils

Test 7 of 10

DIME Test ID: 2021-09-22-18-7
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 09/29/2021
Date Tested: 09/28/2021
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1D
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 30727-75075848
Finish Coating ASTM B695 - Mech Galv
Product Markings U DH
Size 1.125 in
Bolt Length no data in
Measurement Average 2.57 mils

Test 8 of 10

DIME Test ID: 2021-09-22-18-8
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 09/29/2021
Date Tested: 09/28/2021
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1E
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 30727-75075848
Finish Coating ASTM B695 - Mech Galv
Product Markings U DH
Size 1.125 in
Bolt Length no data in
Measurement Average 3.85 mils

Test 9 of 10

DIME Test ID: 2021-09-22-18-9
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 09/29/2021
Date Tested: 09/28/2021
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1F
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 30727-75075848
Finish Coating ASTM B695 - Mech Galv
Product Markings U DH
Size 1.125 in
Bolt Length no data in
Measurement Average 2.64 mils

Test 10 of 10

DIME Test ID: 2021-09-22-18-10
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 09/29/2021
Date Tested: 09/28/2021
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1G
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number 30727-75075848
Finish Coating ASTM B695 - Mech Galv
Product Markings U DH
Size 1.125 in
Bolt Length no data in
Measurement Average 2.99 mils