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Testing Report for 2019-03-13-3-1

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

Project Information

DEA: 101E8904
EFIS: 1016000093
Project ID: 211967
QA Service Level: 1
DIST-CO-RTE-PM: 10-SJ-5-26.5/27.0
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Ariel Mendoza
Structure Rep.: Mohsen Abdelfatah

Sample Information

DIME Sample ID: 2019-03-13-3
TL Number from the TL Form:
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: 3/13/2019
Date that the sample was received by the laboratory/organization performing the testing: 3/21/2019
The quantity of what the sample constitutes: 5
A brief description of the sample: 1" Flat Head Socket Head Cap Screw
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Copper State Bolt and Nut Company

Material Information

Rocap Number(s):
Heat Number(s): 188863
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s):
Bolt Specification: ASTM A449-14
Bolt Length(s): Unknown
Nut Specification: N/A
Washer Specification: N/A
Finish: HDG
Diameter/Size: 1"
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2019-03-13-3-1
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Date Tested: 3/19/2019
Verified Date: 3/19/2019
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:
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): no data
Mfg. Lot Number: 188863
Finish Coating: ASTM F2329 - Hot Dip
Product Markings: CSB 449
Size: 1 in
Bolt Length: 3.75 in
Gage Type: Pass