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Testing Report for 2019-09-18-2-5

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

Project Information

DEA: 100L0204
EFIS: 1013000053
Project ID: 212596
QA Service Level: 1
DIST-CO-RTE-PM: 10-SJ,STA-99-0.0-0.7:24.4-24.8
Work Description: Partial Bridge Replacement
Location Description: ON ROUTE 99 IN RIPON AT THE COUNTY LINE OF SAN JOAQUIN COUNTY AND STANISLAUS COUNTY AT THE STANISLAUS RIVER BRIDGES (29-0013L/R).
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Harminder Deol
Structure Rep.: George Samuel

Sample Information

DIME Sample ID: 2019-09-18-2
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7263
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 9/18/2019
Date that the sample was received by the laboratory/organization performing the testing: 9/18/2019
The quantity of what the sample constitutes: 56
A brief description of the sample: Anchor Rod Assembly
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: DS Brpwn

Material Information

Rocap Number(s):
Heat Number(s): 188896, 21817790, DL17100129
Nut Mfg. Lot Number(s): Nucor
Washer Mfg. Lot Number(s): Technical Stamping Inc
Bolt Specification: ASTM F1554 Gr 105
Bolt Length(s): 25 inches
Nut Specification: ASTM A563
Washer Specification: ASTM F436
Finish: HDG
Diameter/Size: 1-1/8 inch
Bolt Mfg. Lot Number: Alton Steel Inc
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2019-09-18-2-5
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Date Tested: 9/26/2019
Verified Date: 9/27/2019
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.: 1B
Rocap Number: no data
Heat Number(s): 188896
Mfg. Lot Number: no data
Finish Coating: ASTM F2329 - Hot Dip
Product Markings: RED PAINT
Size: 1.125 in
Bolt Length: 25 in
Gage Type: Pass