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Testing Report for 2017-07-07-4-10

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

Project Information

DEA: 07121844
EFIS: 0700000117
Project ID: 3807
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-42.8/47.3
Work Description: CONSTRUCT HOV LANES, RETAINING WALLS AND SOUND WALLS.
Location Description: LOS ANGELES COUNTY IN LOS ANGELES, GLENDALE, AND BURBANK FROM ROUTE 5/134 SEPARATION TO MAGNOLIA BOULEVARD OVERCROSSING
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: James Shih
Structure Rep.: Matthew Remo

Sample Information

DIME Sample ID: 2017-07-07-4
TL Number from the TL Form: C970157
Sample Submitted By Organization: CT QASI - Los Angeles Field Laboratory
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 7/7/2017
Date that the sample was received by the laboratory/organization performing the testing: 7/13/2017
The quantity of what the sample constitutes: 402
A brief description of the sample: 7/8 A325 Bolts, nuts and washers
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Stinger Bridge Iron

Material Information

Rocap Number(s): TT0087693
Heat Number(s): 10460750 Bolt 75065073 Nut B40551 Washer
Nut Mfg. Lot Number(s): 24877-75065073
Washer Mfg. Lot Number(s): 1116-401
Bolt Specification: A325
Bolt Length(s): 2-1/4"
Nut Specification: A563
Washer Specification: F436
Finish: Mechanically Galvanized
Diameter/Size: 7/8"
Bolt Mfg. Lot Number: BM0500
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2017-07-07-4-10
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Date Tested: 7/19/2017
Verified Date: 7/20/2017
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.: 1C
Rocap Number: no data
Heat Number(s): no data
Mfg. Lot Number: 24877-75065073
Finish Coating: ASTM B695 - Mech Galv
Product Markings: U DH
Size: .875 in
Gage Type: Pass