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Testing Report for 2021-09-24-5-3

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

Project Information

DEA: 042W1204
EFIS: 0421000139
Project ID: 215371
QA Service Level: 1
DIST-CO-RTE-PM: 04-CC-580-6.9/7.8
Work Description: REPLACEMENT OF GUSSET PLATES AT VARIOUS LOCATIONS
Location Description: Richmond San Rafael Bridge
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Behzad Halali
Structure Rep.: David Quintana

Sample Information

DIME Sample ID: 2021-09-24-5
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: 9/24/2021
Date that the sample was received by the laboratory/organization performing the testing: 9/27/2021
The quantity of what the sample constitutes: 149
A brief description of the sample: ASTM A490 Fastener Assy
From where was the sample collected: Manufacturer
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):
Washer Mfg. Lot Number(s):
Bolt Specification: A490
Bolt Length(s): 4.5
Nut Specification: n/a
Washer Specification: n/a
Finish: Geomet
Diameter/Size: 1.125
Bolt Mfg. Lot Number: 821308
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2021-09-24-5-3
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Date Tested: 9/29/2021
Verified Date: 10/1/2021
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.: 1B
Rocap Number: no data
Heat Number(s): no data
Mfg. Lot Number: 821308
Finish Coating: ASTM F1136 - Dachromet or Geomet
Product Markings: A490 USA LE
Size: 1.125 in
Bolt Length: 4.5 in
Gage Type: Pass