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Testing Report for 2019-01-28-13-8

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

Project Information

DEA: 024G5204
EFIS: 0214000022
Project ID: 212185
QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA-5-R28.0 - R29.2
Work Description: PIT RIVER BRIDGE DECK & CATWALK REHABILITATION
Location Description: SHASTA COUNTY ABOUT 6 MILES NORTH OF SHASTA LAKE FROM 0.2 MILE SOUTH TO 0.9 MILE NORTH OF PIT RIVER BRIDGE OVERHEAD
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Tofael Anwar
Structure Rep.: Andrew Osullivan

Sample Information

DIME Sample ID: 2019-01-28-13
TL Number from the TL Form: C733280
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (916) 227-7253
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 1/28/2019
Date that the sample was received by the laboratory/organization performing the testing: 2/14/2019
The quantity of what the sample constitutes: 5
A brief description of the sample: A325 Bolt Assembly
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Midwest Structural Products

Material Information

Rocap Number(s):
Heat Number(s):
Nut Mfg. Lot Number(s): 407093A
Washer Mfg. Lot Number(s): 310706
Bolt Specification: A325
Bolt Length(s): 2.25
Nut Specification: A563
Washer Specification: F436
Finish: MG
Diameter/Size: .625
Bolt Mfg. Lot Number: 413227A
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2019-01-28-13-8
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Date Tested: 2/20/2019
Verified Date: 2/20/2019
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): no data
Mfg. Lot Number: 413227A
Finish Coating: ASTM B695 - Mech Galv
Product Markings: A325 N USA
Size: .625 in
Bolt Length: 2.25 in
Gage Type: Pass