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Testing Report for 2017-09-13-2-8

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

Project Information

DEA: 073W2204
EFIS: 0716000011
Project ID: 211948
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-210-R0.0/R15.8
Work Description: REPLACE BRIDGE APPROACH SLABS AND REHABILITATE DECKS.
Location Description: LOS ANGELES COUNTY IN LOS ANGELES AND GLENDALE FROM NORTH CONNECTOR OVERCROSSING TO HONOLULU AVENUE UNDERCROSSING
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Patricia Amadi
Structure Rep.: Adriana Pimienta

Sample Information

DIME Sample ID: 2017-09-13-2
TL Number from the TL Form: C939715
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: 9/13/2017
Date that the sample was received by the laboratory/organization performing the testing: 9/18/2017
The quantity of what the sample constitutes: 5
A brief description of the sample: 3/4 in A307 Galvanized Anchor Rod
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Ulmer Industries

Material Information

Rocap Number(s):
Heat Number(s): 278417- HDG Rod DL16105190 - HDG DH nuts
Nut Mfg. Lot Number(s): 386212B
Washer Mfg. Lot Number(s):
Bolt Specification: F1554 Grade 36
Bolt Length(s): Unknown
Nut Specification: A563-07 grade 1045L
Washer Specification: n/a
Finish: HDG
Diameter/Size: 3/4"
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2017-09-13-2-8
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Date Tested: 9/19/2017
Verified Date: 9/20/2017
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.: 1D
Rocap Number: no data
Heat Number(s): 278417
Mfg. Lot Number: no data
Finish Coating: ASTM F2329 - Hot Dip
Product Markings: no data
Size: .75 in
Bolt Length: 44 in
Gage Type: Pass