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Testing Report for 2017-05-15-3-2

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

Project Information

DEA: STOCK
EFIS: STOCK
Project ID: 88888
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for SMTL stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2017-05-15-3
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT QASI - Bay Area Field Laboratory
Sample Organization Contact: (707) 649-5453
Type of Sample: Verification
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 5/15/2017
Date that the sample was received by the laboratory/organization performing the testing: 5/16/2017
The quantity of what the sample constitutes: 12
A brief description of the sample: A563-DH plain nut
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Universal Industrial Sales

Material Information

Rocap Number(s):
Heat Number(s): 3066492
Nut Mfg. Lot Number(s): W2112
Washer Mfg. Lot Number(s):
Bolt Specification: n/a
Bolt Length(s): Unknown
Nut Specification: A563-DH
Washer Specification: n/a
Finish: Plain
Diameter/Size: 2 1/2"
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2017-05-15-3-2
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Date Tested: 5/23/2017
Verified Date: 5/24/2017
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.: 1B
Rocap Number: no data
Heat Number(s): no data
Mfg. Lot Number: W2112
Finish Coating: Plain
Product Markings: 2H/DH LSF
Size: 2.5 in
Gage Type: Pass