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Testing Report for 2017-03-28-19-1

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

Project Information

DEA: 59912684
EFIS:
Project ID: 8196
QA Service Level: 1
DIST-CO-RTE-PM: 59---
Work Description:
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2017-03-28-19
TL Number from the TL Form: Unknown
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: 3/28/2017
Date that the sample was received by the laboratory/organization performing the testing: 5/5/2017
The quantity of what the sample constitutes: 15
A brief description of the sample: Rocap Assembly
From where was the sample collected: Distributor
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: JLK Industries

Material Information

Rocap Number(s): 04281710
Heat Number(s):
Nut Mfg. Lot Number(s): 23373-6214073403
Washer Mfg. Lot Number(s): 299721
Bolt Specification: A325
Bolt Length(s): 5
Nut Specification: A563-DH
Washer Specification: F436
Finish: HDG
Diameter/Size: 1
Bolt Mfg. Lot Number: 363712A
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2017-03-28-19-1
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Date Tested: 5/8/2017
Verified Date: 5/9/2017
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: 04281710
Heat Number(s): no data
Mfg. Lot Number: 363712A
Finish Coating: ASTM F2329 - Hot Dip
Product Markings: A325 N
Size: 1 in
Bolt Length: 5 in
Gage Type: Pass