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Sample Record for 2019-12-11-21

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

Project Information

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

Sample Information

DIME Sample ID: 2019-12-11-21
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: 274
A brief description of the sample: 7/8-9 GR DH HV MG HEX NUT w/ blue dye
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Structural and Steel Products

Material Information

Rocap Number(s):
Heat Number(s): DL18102872
Nut Mfg. Lot Number(s): 409874A
Washer Mfg. Lot Number(s):
Bolt Specification: n/a
Bolt Length(s): Unknown
Nut Specification: DH
Washer Specification: n/a
Finish: mechanically galvanized to ASTM B695
Diameter/Size: 7/8"
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s): not required. snug tight

Test Results

Test 1 of 7

DIME Test ID: 2019-12-11-21-1
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: 12/23/2019
Date Tested: 12/20/2019
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 Load
Test Result Compliance:
Additional Comments When Verified:
Number of Samples 1
SampleBolt Mfg. Lot NumberSize (in)Peak Load (lbf)Peak Load (kN)CommentsTested By
1A409874A81937Nut Proof Loadspaine
UTM 450kip
Temperature 72 f

Test 2 of 7

DIME Test ID: 2019-12-11-21-2
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 12/23/2019
Date Tested: 12/20/2019
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 409874A
Finish Coating ASTM B695 - Mech Galv
Product Markings DH N
Size .875 in
Gage Type NA

Test 3 of 7

DIME Test ID: 2019-12-11-21-3
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 12/23/2019
Date Tested: 12/20/2019
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 409874A
Finish Coating ASTM B695 - Mech Galv
Product Markings DH N
Size .875 in
Gage Type NA

Test 4 of 7

DIME Test ID: 2019-12-11-21-4
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Verified Date: 12/23/2019
Date Tested: 12/20/2019
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 409874A
Finish Coating ASTM B695 - Mech Galv
Product Markings DH N
Size .875 in
Gage Type NA

Test 5 of 7

DIME Test ID: 2019-12-11-21-5
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: 12/20/2019
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 409874A
Finish Coating ASTM B695 - Mech Galv
Product Markings DH N
Size .875 in
Bolt Length no data in
Measurement Average 4.15 mils

Test 6 of 7

DIME Test ID: 2019-12-11-21-6
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: 12/20/2019
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 409874A
Finish Coating ASTM B695 - Mech Galv
Product Markings DH N
Size .875 in
Bolt Length no data in
Measurement Average 4.01 mils

Test 7 of 7

DIME Test ID: 2019-12-11-21-7
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: 12/20/2019
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 409874A
Finish Coating ASTM B695 - Mech Galv
Product Markings DH N
Size .875 in
Bolt Length no data in
Measurement Average 3.28 mils