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: 2021-10-28-7

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: 10/28/2021

Date that the sample was received by the laboratory/organization performing the testing: 11/03/2021

The quantity of what the sample constitutes: 50

A brief description of the sample: ASTM F436 Washer MG, 1-inch diam

From where was the sample collected: Manufacturer

Laboratory sample identification:

Structure unique identifier:

Structure name: Richmond San Rafael Bridge

The fabricator/manufacturer/facility name: LeJeune Bolt Company

Material Information

Rocap Number(s): L1414551

Heat Number(s): 202539

Nut Mfg. Lot Number(s): n/a

Washer Mfg. Lot Number(s): 1120-636

Bolt Specification: n/a

Bolt Length(s):

Nut Specification: n/a

Washer Specification: ASTM F436

Finish: Mech Galv

Diameter/Size: 1 inch

Bolt Mfg. Lot Number: n/a

Rocap Test Requirement(s):

Lubricant Requirements(s):

Test Results

Test 1 of 2

DIME Test ID: 2021-10-28-7-1

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: 11/08/2021

Date Tested: 11/04/2021

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	1120-636
Finish Coating	ASTM B695 - Mech Galv
Product Markings	TSI F436
Size	1 in
Bolt Length	no data in
Measurement Average	4.66 mils

Test 2 of 2

DIME Test ID: 2021-10-28-7-2

Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)