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Testing Report for 2019-10-16-6-9

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

Project Information

DEA: 07288604
EFIS: 0700021080
Project ID: 208945
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-710-6.0-9.4
Work Description: Gerald Desmond Bridge Replacement - A Design Build project. IQA samples will be selected by Port/Caltrans representatives and sent to Translab for testing.
Location Description: Port of Long Beach (District 7)
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer:
Structure Rep.:

Sample Information

DIME Sample ID: 2019-10-16-6
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (916) 227-7253
Type of Sample: Acceptance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 10/16/2019
Date that the sample was received by the laboratory/organization performing the testing: 10/21/2019
The quantity of what the sample constitutes: 6
A brief description of the sample: A490 Bolts
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: LeJeune

Material Information

Rocap Number(s):
Heat Number(s): 75073905 6214661005 140647 75067668 10508080 6214506106 262342 75070176 6214552009 277861
Nut Mfg. Lot Number(s): 30581-6214661005 28846-6214661005 27185-6214506106 27807-6214552009
Washer Mfg. Lot Number(s): 0115-716 D3644 114 D4851
Bolt Specification: A490
Bolt Length(s): 6" 7" 10"
Nut Specification: A563 DH
Washer Specification: F436
Finish: Geomet
Diameter/Size: 1.25"
Bolt Mfg. Lot Number: 050919-4FM 041719-1CM 051519-7EM 27128-105
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2019-10-16-6-9
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Date Tested: 10/25/2019
Verified Date: 10/29/2019
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: 050919-4FM
Finish Coating: ASTM F1136 - Dachromet or Geomet
Product Markings: BBC A490
Size: 1.25 in
Bolt Length: 10 in
Gage Type: Pass