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Sample Record for 2019-12-11-28

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

Project Information

Project ID: 213741 DEA: 07325704 EFIS: 0716000089 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: AWI Builders Inc
Contractor Address: 7831 Paramount Bl, Pico Rivera Ca 90660
Resident Engineer: Mashhur Ali Structure Rep.: Nelson Parada

Sample Information

DIME Sample ID: 2019-12-11-28
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: 12/11/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 48 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): 188868
Nut Mfg. Lot Number(s): 415208A
Washer Mfg. Lot Number(s): N/A
Bolt Specification: F1554 Gr. 55
Bolt Length(s): 30"
Nut Specification: A563 Gr. 2H
Washer Specification: N/A
Finish: Plain
Diameter/Size: 7/8" All Thread Bolt
Bolt Mfg. Lot Number: N/A
Rocap Test Requirement(s): NA
Lubricant Requirements(s):

Test Results

Test 1 of 4

DIME Test ID: 2019-12-11-28-1
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Verified Date: 12/17/2019
Date Tested: 12/17/2019
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) 188868
Mfg. Lot Number no data
Finish Coating Plain
Product Markings YELLOW PAINT
Size .875 in
Bolt Length 30 in
Gage Type Pass

Test 2 of 4

DIME Test ID: 2019-12-11-28-2
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 12/17/2019
Date Tested: 12/17/2019
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 415208A
Finish Coating Plain
Product Markings DH N
Size .875 in
Gage Type Pass

Test 3 of 4

DIME Test ID: 2019-12-11-28-3
Test Method: ASTM A370-15: Standard Test Methods and Definitions for Mechanical Testing of Steel Products (Tensile - Round Sample)
Verified Date: 12/17/2019
Date Tested: 12/17/2019
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:
Number of Samples 2
SampleHeat NumberDiameter (in)Area (sqin)Stress at Offset (psi)Tensile Strength (psi)Elongation in 4 x d (%)Tested By
1188868.5040.19950648858559031.4FSaylor
2188868.5040.19950653078561530.7FSaylor
UTM 67KIP
Temperature 72 f

Test 4 of 4

DIME Test ID: 2019-12-11-28-4
Test Method: ASTM F606-14a: Standard Test Methods for Determining the Mechanical Properties of Externally and Internally Threaded Fasteners, Washers, Direct Tension Indicators, and Rivets (Proof Load)
Verified Date: 12/17/2019
Date Tested: 12/17/2019
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: Nut Proof
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleBolt Mfg. Lot NumberSize (in)Peak Load (lbf)Peak Load (kN)CommentsTested By
1415208A80864Nut Prooffsaylor
UTM 450kip
Temperature 72 f