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Testing Report for 2019-08-02-1-3

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

Project Information

DEA: 080J0804
EFIS: 0800000283
Project ID: 210837
QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-15-34.7/51.6
Work Description: (Alternative Delivery) DESIGN-BUILD OF THE INTERSTATE 15 EXPRESS LANES PROJECT
Location Description: Riverside County and SBD-15-0.0/1.3
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Roy Fisher (reports)
Structure Rep.: Roy Fisher

Sample Information

DIME Sample ID: 2019-08-02-1
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: 8/2/2019
Date that the sample was received by the laboratory/organization performing the testing: 8/2/2019
The quantity of what the sample constitutes: 45
A brief description of the sample: F1554 Anchor Bolt Assembly
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue Circle

Material Information

Rocap Number(s):
Heat Number(s):
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s):
Bolt Specification: 1 1/2 -6 x 54 F1554 grade 55 Galv
Bolt Length(s): Unknown
Nut Specification: 1 1/2
Washer Specification: NA
Finish:
Diameter/Size: Unknown
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2019-08-02-1-3
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Date Tested: 8/12/2019
Verified Date: 8/14/2019
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.: 1A
Rocap Number: no data
Heat Number(s): 1202006745
Mfg. Lot Number: no data
Finish Coating: ASTM F2329 - Hot Dip
Product Markings: YELLOW PAINT
Size: 1.5 in
Bolt Length: 54 in
Gage Type: Pass