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Sample Record for 2019-03-13-3

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

Project Information

Project ID: 211967 DEA: 101E8904 EFIS: 1016000093 QA Service Level: 1
DIST-CO-RTE-PM: 10-SJ-5-26.5/27.0
Work Description: REPAIR BRIDGE CROSSFRAMES.
Location Description: SAN JOAQUIN COUNTY IN STOCKTON AT STOCKTON CHANNEL VIADUCT
Contractor Name: ABHE & SVOBODA, INC.
Contractor Address: 18100 Dairy Lane, Jordan, MN 55352
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 HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 03/13/2019
Date that the sample was received by the laboratory/organization performing the testing: 03/21/2019
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 Results

Test 1 of 3

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)
Verified Date: 03/19/2019
Date Tested: 03/19/2019
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 188863
Finish Coating ASTM F2329 - Hot Dip
Product Markings CSB 449
Size 1 in
Bolt Length 3.75 in
Gage Type Pass

Test 2 of 3

DIME Test ID: 2019-03-13-3-2
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: 03/19/2019
Date Tested: 03/19/2019
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 188863
Finish Coating ASTM F2329 - Hot Dip
Product Markings CSB 449
Size 1 in
Bolt Length 3.75 in
Measurement Average 3.94 mils

Test 3 of 3

DIME Test ID: 2019-03-13-3-3
Test Method: ASTM E18-15: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 03/19/2019
Date Tested: 03/19/2019
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 188863
Finish Coating ASTM F2329 - Hot Dip
Product Markings CSB 449
Size 1 in
Bolt Length 3.75 in
Hardness Reading Scale C Scale
Hardness Reading Average 28.37
Spacing Ok