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Sample Record for 2017-12-14-30

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

Project Information

Project ID: 212205 DEA: 044K7104 EFIS: 0417000340 QA Service Level: 1
DIST-CO-RTE-PM: 04-SCL-35-9.5, 9.50
Work Description: construct tie-back wall
Location Description:
Contractor Name: GRANITE ROCK COMPANY
Contractor Address: 5225 HELLYER AVE, SUITE 220, SAN JOSE, CA 95138
Resident Engineer: Moaid Laymoun Structure Rep.: Dave Nguyen

Sample Information

DIME Sample ID: 2017-12-14-30
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 12/14/2017
Date that the sample was received by the laboratory/organization performing the testing: 12/14/2017
The quantity of what the sample constitutes: 3 from lot of 18
A brief description of the sample: 1/2 x 4 bolt
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):
Heat Number(s): nf15203956
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s):
Bolt Specification: A325
Bolt Length(s): 4
Nut Specification: N/a
Washer Specification: N/A
Finish: HDG
Diameter/Size: 1/2
Bolt Mfg. Lot Number: St Louis Screw
Rocap Test Requirement(s): No
Lubricant Requirements(s): No
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2017-12-14-30-1
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 with Wedge)
Verified Date: 12/19/2017
Date Tested: 12/18/2017
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test: A325
Test Result Compliance:
Additional Comments When Verified:
Number of Bolt Samples 1
SampleBolt Mfg. Lot NumberSize (in)Peak Load (lbf)Peak Load (kN)Wedge Angle (deg)CommentsTested By
1AS28-380-171/2\"2004189.110A325Brian
UTM 400KIP
Temperature no data

Test 2 of 3

DIME Test ID: 2017-12-14-30-2
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Verified Date: 12/19/2017
Date Tested: 12/18/2017
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number G9079
Finish Coating Plain and ASTM F2329 - Hot Dip
Product Markings A325 N
Size .5 in
Bolt Length 4 in
Gage Type Pass

Test 3 of 3

DIME Test ID: 2017-12-14-30-3
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 12/19/2017
Date Tested: 12/18/2017
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number G9079
Finish Coating Plain and ASTM F2329 - Hot Dip
Product Markings A325 N
Size .5 in
Bolt Length 4 in
Measurement Average 3.57 mils