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Testing Report for 2019-12-11-30-4

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

Project Information

DEA: 07325704
EFIS: 0716000089
Project ID: 213741
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-1.7
Work Description: BUILDING CONSTRUCTION IN LOS ANGELES COUNTY IN SANTA FE SPRINGS AT 14044 FREEWAY DRIVE.
Location Description: Santa Fe Springs, At 14044 Freeway Drive.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Mashhur Ali
Structure Rep.: Nelson Parada

Sample Information

DIME Sample ID: 2019-12-11-30
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: 12/11/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 108 EA
A brief description of the sample: F1554 Anchor Bolt
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name: Building Work
The fabricator/manufacturer/facility name: Cordova Bolt

Material Information

Rocap Number(s): N/A
Heat Number(s): 3063603
Nut Mfg. Lot Number(s): 413065A
Washer Mfg. Lot Number(s): N/A
Bolt Specification: F1554 Gr. 55
Bolt Length(s): 10"
Nut Specification: A563 Gr. DH
Washer Specification: N/A
Finish: Plain
Diameter/Size: 5/8" with 3" hook
Bolt Mfg. Lot Number: N/A
Rocap Test Requirement(s): NA
Lubricant Requirements(s):

Test Information

DIME Test ID: 2019-12-11-30-4
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Date Tested: 12/16/2019
Verified Date: 12/17/2019
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): no data
Mfg. Lot Number: 413065A
Finish Coating: Plain
Product Markings: DH N
Size: .625 in
Gage Type: Pass