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Testing Report for 2020-06-12-1-2

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

Project Information

DEA: 033F5104
EFIS: 0313000020
Project ID: 212324
QA Service Level: 1
DIST-CO-RTE-PM: 03-YUB-20-R18.1/R20.1
Work Description: Construct bridge, realign curve & widen shoulders.
Location Description: Construction on state highway in Yuba County near Smartsville from the Yuba River Bridge to 0.3 mile east of Smartsville Road.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Aaron Chamberlin
Structure Rep.: Brent Bullard

Sample Information

DIME Sample ID: 2020-06-12-1
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7263
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 6/12/2020
Date that the sample was received by the laboratory/organization performing the testing: 6/16/2020
The quantity of what the sample constitutes: 4
A brief description of the sample: 3/4" gr Dh Nut
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Gerlinger

Material Information

Rocap Number(s):
Heat Number(s):
Nut Mfg. Lot Number(s): 422611D
Washer Mfg. Lot Number(s):
Bolt Specification: n/a
Bolt Length(s): Unknown
Nut Specification: ASTM A563-15
Washer Specification: n/a
Finish: Hot Dipped ASTM F2329-15
Diameter/Size: 3/4"
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Information

DIME Test ID: 2020-06-12-1-2
Test Method: ASME B1.2-83r01: (Plug Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Plug Gage)
Date Tested: 6/17/2020
Verified Date: 6/17/2020
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: 422611D
Finish Coating: ASTM F2329 - Hot Dip
Product Markings: DH N
Size: .75 in
Gage Type: Pass