Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212794 DEA: 024F7804 EFIS: 0213000032
QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA,LAS,PLU,SHA,SIS,TRI-5-22087-25.7
Work Description: CMS SIGNS IN SHASTA COUNTY
Location Description: IN BUTTE, LASSEN, PLUMAS, SHASTA, SISKIYOU AND TRINITY COUNTIES IN VARIOUS LOCATIONS.
Contractor Name: Tullis Inc
Contractor Address: 16951 Clear Creek Road, Redding, CA 96001
Resident Engineer: Joel Gasik Structure Rep.: Nicholas McLean
DIME Sample ID: 2019-12-11-16
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
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: 12/18/2019
The quantity of what the sample constitutes: 82
A brief description of the sample: 3/4" DTI Washer ASTM F959
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Structural and Steel Products
Rocap Number(s):
Heat Number(s): 281850
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s): C27
Bolt Specification: n/a
Bolt Length(s): Unknown
Nut Specification: n/a
Washer Specification: F959 galvanized DTI type 1
Finish: MG
Diameter/Size: 3/4"
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s): not required. snug tight
DIME Test ID: 2019-12-11-16-1
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 12/23/2019
Date Tested: 12/19/2019
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
|
C27
|
Finish Coating
|
ASTM B695 - Mech Galv
|
Product Markings
|
325 C27
|
Size
|
.75 in
|
Bolt Length
|
no data in
|
Measurement Average
|
3.62 mils
|
DIME Test ID: 2019-12-11-16-2
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 12/23/2019
Date Tested: 12/19/2019
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.
|
1B
|
Rocap Number
|
no data
|
Heat Number(s)
|
no data
|
Mfg. Lot Number
|
C27
|
Finish Coating
|
ASTM B695 - Mech Galv
|
Product Markings
|
325 C27
|
Size
|
.75 in
|
Bolt Length
|
no data in
|
Measurement Average
|
3.65 mils
|
DIME Test ID: 2019-12-11-16-3
Test Method: ASTM B499-14: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 12/23/2019
Date Tested: 12/19/2019
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.
|
1C
|
Rocap Number
|
no data
|
Heat Number(s)
|
no data
|
Mfg. Lot Number
|
C27
|
Finish Coating
|
ASTM B695 - Mech Galv
|
Product Markings
|
325 C27
|
Size
|
.75 in
|
Bolt Length
|
no data in
|
Measurement Average
|
3.99 mils
|