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Testing Report for 2020-10-28-1-4

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

Project Information

Project ID: 213749 DEA: 120C1104 EFIS: 1200000633 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-57-20.3/21.6
Work Description: WIDEN BRIDGES AND CONSTRUCT RW, SW, HMA, JPCP AND ELECTRICAL SYSTEMS.
Location Description: ORANGE COUNTY IN BREA FROM 0.6 MILE SOUTH TO 0.7 MILE NORTH OF LAMBERT ROAD UNDERCROSSING
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Imad Abugharbieh Structure Rep.: Bassem Kabbara

Sample Information

DIME Sample ID: 2020-10-28-1
TL Number from the TL Form: na
Sample Submitted By Organization: CT QASI - Bay Area Field Laboratory
Sample Organization Contact: (707) 649-5453
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 10/28/2020
Date that the sample was received by the laboratory/organization performing the testing: 10/28/2020
The quantity of what the sample constitutes: 400
A brief description of the sample: Anchor Bolt Samples
From where was the sample collected: Fabricator
Laboratory sample identification: na
Structure unique identifier:
Structure name: na
The fabricator/manufacturer/facility name: Universal Industrial Sales

Material Information

Rocap Number(s): na
Heat Number(s): 1202022608
Nut Mfg. Lot Number(s): na
Washer Mfg. Lot Number(s): na
Bolt Specification: F1554-55
Bolt Length(s): 5'-0"
Nut Specification: na
Washer Specification: na
Finish: HDG/ Plain
Diameter/Size: 2-1/2"
Bolt Mfg. Lot Number: na
Rocap Test Requirement(s): na
Lubricant Requirements(s): na

Test Information

DIME Test ID: 2020-10-28-1-1
Test Method: ASME B1.2-83r01: (Ring Gage) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Ring Gage)
Verified Date: 11/04/2020
Date Tested: 11/03/2020
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. 1D
Rocap Number no data
Heat Number(s) 1202022658
Mfg. Lot Number no data
Finish Coating ASTM F2329 - Hot Dip
Product Markings YELLOW PAINT
Size 2.5 in
Bolt Length 60 in
Gage Type Pass