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Testing Report for 2017-06-15-3-1

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

Project Information

DEA: 113A0534
EFIS: 1117000127
Project ID: 212468
QA Service Level: 1
Work Description:
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Trung Minh Tran
Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2017-06-15-3
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: 6/15/2017
Date that the sample was received by the laboratory/organization performing the testing: 6/15/2017
The quantity of what the sample constitutes: 2
A brief description of the sample: F1554 gr.55 anchor assembly
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: UIS

Material Information

Rocap Number(s): n/a
Heat Number(s): PL16106308
Nut Mfg. Lot Number(s): 24875, NF15200634
Washer Mfg. Lot Number(s): n/a
Bolt Specification: F1554 gr. 55
Bolt Length(s): 3'-0"
Nut Specification: A563-DH
Washer Specification: n/a
Finish: HDG,plain
Diameter/Size: 1 1/2" x 3'-0"
Bolt Mfg. Lot Number: PL1610630802
Rocap Test Requirement(s): none
Lubricant Requirements(s):

Test Information

DIME Test ID: 2017-06-15-3-1
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Date Tested: 6/22/2017
Verified Date: 6/23/2017
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:
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): PL16106308
Mfg. Lot Number: no data
Finish Coating: ASTM F2329 - Hot Dip
Product Markings: YELLOW PAINT
Size: 1.5 in
Bolt Length: 36 in
Gage Type: Pass