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Testing Report for 2017-04-13-6-6

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

Project Information

DEA:
EFIS: 0000001155
Project ID: 212152
QA Service Level: 1
DIST-CO-RTE-PM: 11--78-12.9/12.9
Work Description: enter upon State Highway right of way in San Diego County, City of San Marcos, on Route 78, at post mile12.91, to place temporary traffic control to relocate an existing overhead sign and to install traffic signal outside Caltrans right of way, as shown on the attached plans, in accordance with the
Location Description: ROUTE 78, SAN MARCOS
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Ralph Yanzon
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2017-04-13-6
TL Number from the TL Form: C953703
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (916) 227-7253
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 4/13/2017
Date that the sample was received by the laboratory/organization performing the testing: 4/17/2017
The quantity of what the sample constitutes: 3
A brief description of the sample: F1554 Grade 55 HDG Anchor Bolts
From where was the sample collected: Distributor
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Portland Bolt

Material Information

Rocap Number(s):
Heat Number(s): 511914
Nut Mfg. Lot Number(s): DDTB
Washer Mfg. Lot Number(s): 9962G
Bolt Specification: F1554 G55 HDG
Bolt Length(s): 32
Nut Specification: A194/A563 HDG
Washer Specification: F436 HDG
Finish: F2329/A153
Diameter/Size: 2.5
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2017-04-13-6-6
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Date Tested: 4/19/2017
Verified Date: 4/19/2017
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): no data
Mfg. Lot Number: DDTB
Finish Coating: ASTM A153 - Hot Dip
Product Markings: 2H DH ND
Size: 2.5 in
Gage Type: Pass