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Testing Report for 2017-11-20-1-3

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

Project Information

DEA: 022C0904
EFIS: 0200000161
Project ID: 211669
QA Service Level: 1
DIST-CO-RTE-PM: 02-PLU-70-50.6/51.7
Work Description: BRIDGE WIDENING AND DECK REPLACEMENT, HMA, MGS AND CULVERT REPLACEMENT
Location Description: PLUMAS COUNTY NEAR QUINCY FROM 0.6 MILE WEST TO 0.5 MILE EAST OF SPRING GARDEN BRIDGE OVERHEAD
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Ronald Collins
Structure Rep.: Jeffrey Rothgery

Sample Information

DIME Sample ID: 2017-11-20-1
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: 11/20/2017
Date that the sample was received by the laboratory/organization performing the testing: 11/20/2017
The quantity of what the sample constitutes: One lot
A brief description of the sample: 1 x 30 A449 All thread assembly
From where was the sample collected: Distributor
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Portland Bolt Manufacturing

Material Information

Rocap Number(s):
Heat Number(s): A164782
Nut Mfg. Lot Number(s): 26288-6214401705
Washer Mfg. Lot Number(s): Nucor/PBM
Bolt Specification: A449
Bolt Length(s): 30
Nut Specification: A563
Washer Specification: A36
Finish: HDG
Diameter/Size: 1
Bolt Mfg. Lot Number: Vulcan
Rocap Test Requirement(s): No
Lubricant Requirements(s): Yes

Test Information

DIME Test ID: 2017-11-20-1-3
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Date Tested: 11/28/2017
Verified Date: 11/29/2017
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.: 1A
Rocap Number: no data
Heat Number(s): A164782
Mfg. Lot Number: no data
Finish Coating: ASTM F2329 - Hot Dip
Product Markings: A449
Size: 1 in
Bolt Length: 30 in
Gage Type: Pass