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Sample Record for 2017-03-23-1

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

Project Information

Project ID: 211768 DEA: 043K1104 EFIS: 0417000079 QA Service Level: 1
DIST-CO-RTE-PM: 04-SF-80-8.3, 8.30
Work Description: Replace SAS tower anchor rod grout
Location Description: Bay Bridge
Contractor Name: CALIFORNIA ENGINEERING CONTRACTORS, INC.
Contractor Address: 20 HAPPY VALLEY ROAD, PLEASANTON CA 94566
Resident Engineer: Roberto Borja Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2017-03-23-1
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: 03/23/2017
Date that the sample was received by the laboratory/organization performing the testing: 03/30/2017
The quantity of what the sample constitutes: 1 lot of 46 spares
A brief description of the sample: 4 inch HHN 0.031 oversize threads
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Dyson Corp

Material Information

Rocap Number(s): N/A
Heat Number(s): 73096608
Nut Mfg. Lot Number(s): TJU2
Washer Mfg. Lot Number(s): N/A
Bolt Specification: N/A
Bolt Length(s): N/A
Nut Specification: ASTM A194/A153/F2329
Washer Specification: N/A
Finish: HDG wax and dye
Diameter/Size: 4 inch with 0.031 oversize threads
Bolt Mfg. Lot Number: N/A
Rocap Test Requirement(s):
Lubricant Requirements(s):
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2017-03-23-1-1
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: 04/04/2017
Date Tested: 04/03/2017
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 TJU2
Finish Coating ASTM F2329 - Hot Dip
Product Markings SH D/N
Size 4 in
Bolt Length no data in
Measurement Average 3.7 mils

Test 2 of 2

DIME Test ID: 2017-03-23-1-2
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 04/04/2017
Date Tested: 04/04/2017
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 TJU2
Finish Coating ASTM F2329 - Hot Dip
Product Markings 2H D/N
Size 4 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 19.92
Spacing Ok