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Testing Report for 2017-10-16-1-1

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

Project Information

DEA: 06471504
EFIS: 0600000464
Project ID: 209146
QA Service Level: 1
DIST-CO-RTE-PM: 06-TUL-99-39.6/41.3
Work Description: RECONSTRUCT INTERCHANGE WITH NEW PUMPING PLANT.
Location Description: TULARE COUNTY AT GOSHEN FROM 0.9 MILE NORTH OF ROUTE 99/198 WEST SEPARATION TO 0.2 MILE NORTH OF NORTH GOSHEN OVERHEAD
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Brent Haroldsen
Structure Rep.: Peter Moua

Sample Information

DIME Sample ID: 2017-10-16-1
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT QASI - Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7263
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 10/16/2017
Date that the sample was received by the laboratory/organization performing the testing: 10/23/2017
The quantity of what the sample constitutes: 3
A brief description of the sample: 1 X 12 Anchor Rod
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CK Johnson Industries

Material Information

Rocap Number(s):
Heat Number(s):
Nut Mfg. Lot Number(s): 26307
Washer Mfg. Lot Number(s): 0517-523
Bolt Specification: F1554 Gr. 150
Bolt Length(s): 12
Nut Specification: A563 DH
Washer Specification: F436
Finish: HDG
Diameter/Size: 1
Bolt Mfg. Lot Number: 75065295
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2017-10-16-1-1
Test Method: ASTM F606-14a: Standard Test Methods for Determining the Mechanical Properties of Externally and Internally Threaded Fasteners, Washers, Direct Tension Indicators, and Rivets (Proof Load)
Date Tested: 10/25/2017
Verified Date: 10/26/2017
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: Nut Proof
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

Number of Samples: 1
Sample Bolt Mfg. Lot Number Size (in) Peak Load (lbf) Peak Load (kN) Comments Tested By
1A S2922817 1\" 93087 414.07 Nut Proof Fred
UTM: 400KIP
Temperature: 72 F