HomeMy WebLinkAboutCERTIFICATE OF INSPECTIONI
I I'llill,ft 21ALLFASTENERS
SMWCE I WLIJIPMW I.SUPPLY FOR ALL YOUR FASTENINP MOWS
SKY International Co.,Ltd. SCANNED
BY
TU.S6 III =837760/60/70 FMITS 411 MMO w unty
CERTIFICATE OF wmcrm
FIMIUMLIC WASM
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REPORT W
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NO 1 24VILIN RojuNal TwWww
REPM DATE
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FARTNUNISM
VIA51TR Lot NO
HF06=111 I UFA
DtSLWMDIJ
T454HARDROUNDWASIFER
1 1/2
WASHER MFFE IAL
�45CARBWSFM
FINIMI
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IDIMMS
STANDARD
TEST VALUE
UNIT
SAMPLE ACC R
IJA81 - 14301
13.95-14.20
MM
8 8 0
26.188 - 27.813
26.35 - 26.70
MM
8 0
2.464 - 4A95
2.50 a 2,70
Mm
8 a 0
IM&PEC rmv
WL-LIVICATION: ASTM P4362011 SAMFUW STANDARD AS&I E 81 814-2011
7HARACITEREMIC STANDARD TESTVALUE UNIT SAMPLE ACC REJ
SURFACE . HARDNESS 26-45 28.40 1111c 9 9 0
MASHER FINISH INSPEC�TW INSI'M710N :2015112ns
LKCU=ATWN: ASTM F2M H 0 G - 2011 . I SAMPLM STANDUD: ASME 911162011
CHARACTERISTIC STANDARD TESTVALUE UNIT Sk-UPLE ACC REJ
IUCKNESSOPODATING >43 43.5-30.00 9 8 0
�pmrwAvat, Am f4m 2ci I
CHIMMICAL ELEMENT04) c Ma S 51 p Ni cr 6
0.056 IIAX 0. 040 W
TEST VALUE 0.47 0.52 0.005 0 . .22 0.012 0.02 6.04 0.0-1
Marking: F436 & H
ttcmae� urbis corocutc h vaW whh sliwac of Han 211 EaV,
2Siiplu usting confam to Lk rujaimotents of sju Illmdon.
Tbh ust rrpm it rewarisible Jar deSI&A umphs ouly.
I.QuAlty "ciII c6darms to ISO 900 1. mquirenewl Ond cenihid by U�ntv IN7 ft1tGEN= w;ih cerflficaw co1JQI30S03RL
4AI(ftstam ra"t the requircoucats of ft (FQA)nd mords orcpmj1bnce am ou rile.
SIGN ATURE:
I Y
Niw, York Clevelahill
Lds Angelis NeW§ki
69 Orchard Street 959 Oke Road -
5450 W 83rd Street 806 8th St.i6et
Ramsey, New Jerseji 07446 Mediria, Ohio 44256
Los.Angelei; California 90045 �Gothenburg, Nebraska 69138
Tel 800 577 3171 To 888 850060
Tel 3�04106007 TaF 855 330 2210
Fax .201783 8840 Fax 440 232 6062
Fax 866 553 7702 Fax 308 537 3500
0 W.E.
_0 s-alesftlWengrOxom I www.911faMenernorn
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SLSB GALVANIZING'CERTIFICATION OF CONFORMANCE
SLSB Part#-,
Ddscription,
QUaritity:
Original ManUfacturees Lot#:
Outtide proCe6S!hg POMI
LO,TIJOB#
MA06�i)200
Y2X 2 A82&1
1:22567,
036647
8LI9707
G6347
TM aboverparts woee puilO�.Aiwd di made by $LSB, and
havebeen sent out to be galvanized t6 meet the fbildiving ASTM specificatiton
(CHECKONE)
HOT DIP GALVANIZING r2329 y
MECHANICAL GALVANIZING 13695
DATE: 01113/1
"Aftaclied is a galvanizing oertirkation from vendor and on'
ginal tolt ceNfication
LOT N: G63471-036647 gg.1 of I
TEST REPORT
A325A
rRrMlqTRV FROM SLAW. MATFRIAI:SUPPLIER-
SISB, LLC-db*,SLlA6WScrtw &-Bolt
210 Acce�lllvdi
Po Btil Z
Midis6n, IL 62060
Pil: 900.237-7059,
IPAX-. A4�389-7516
GRADE,: 1OB30
1""0-10258400
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OTHER
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510ESouthl St.
Wrigbt City, MO 63390
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qw) - 1 Rwoi+-- W - Infilirmati6n,
OWNER. I SHIP TO:
S118X1.q, �STEEL 4 'PUPPLY
q26' JOANVOW) ROAD
SPARTAN13URG
J1FERALLOY
190OW&K.".0.
DATE- :8/14/17
I SC 2-9.303)
BML,OF LADING.-
607 - 161857 - 1'01
PARTNO:
4410&4
IffEATWIMCOIL'
270'8651 -2766651-2
SIZ I E.,
.2500, X '60. 060 )c 190. boo'
SKID NO:
428193
PRODUCM
Hit PL36, A16
TAG-NUMBERs
11�676 - -03.
CUSrOMER. PO NUMBER:
VP' 59 5,612 - S
PRQCESSEDiASi
ASTM A36 Structural,fteel
PlAte
REFERENCING:
ASTM, A-36 Carbon Struct�iral 'gt�661
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p
61
Si
cu
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OISD 9001-26 08 REGI:ST9RIKD:
NOTICE,YERALLOYMAKES NO RkPMENtATION ORYARRANTY
AS TO THE ]INFORMATION CONTAINED IN THIS -XIT1,0117. The valy.es
published on thWrep"i-cf-Informallon'ary tra,nserl,bed frolm Information
prwided by thc�owncr and the niinit'i suppliers includirig itift, tdfink�
faboratarks, etc. Tfils iii NOT a cerflneW of �IiiiWcadowfnso. ectiorl; air grade.
'This materijil,processedat,.&.shipped from:
FERALLOYCHARLESTON
CHARLEST.9141 DIVISION
1620" NORTH STEELI CTRCLZ
IfUGER
, SC 29450
155784 Mmo SIM �RICATORS LLC 326344 $9562 441&AT)
�T ,ZER: 2708651 CUSTO� PO: 13490 PAGE 2 OF 2
I
ITIRY COY947 D
HEAT ARMUCA: 27036SI CUS-�,,R PD: m6c, I�OF 3
P40-Box 2259
k. vidwanii.,se Z9165
SOMISISKIN STEEL AND-30M.Y.Pe
TO: F;; �Fa im
�OLPMAWOCA. IW 31401
eaugo k'W , Idth ;2380 - HI . N x Go.ociokiw
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Pat N 441041
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270963L,.il .45 .012-001 .02 .09 .04 M -01 -006 .021 .004 ODO .007 �DU .4109 .002
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cm, �hv - fam and rovarsoslaa of incur steel - par)QIW� sai�,x "r a0knowledrount.
Toomile Tnsilnq� Whon appifriblp; Is parfacascI ln.awmda� wlib�SLTTH h�370 speclficatibm�
sp.w!n6n'ls saibleod-to standard rectnugular tPst�mfiviratim 010mc4,3 of hm K-310,
Wish &.2"91-9of Strangth tp�-Winil�od abC.2s iffilat.
this Eatorial has been prodmod In empliance with tho kbomistry,and ostaJollshvif 6111mo-practiM3
1 - � 11 - ad - If " "if i - - ' al. " ' EJ
of the crder spoz Icatioi. materi is wdir -to.a rbeaicel ion eodydia if
jhISIsel' teStfigLiS noi a raqidfemc,�i cf tho seztgewrls oiclet, testing Is selt poviiihaed by ibe
We htrebY cortily the abcw* Information is carrut-as contained ic the rVoords of the cowratim.
leylo skin agbert Moses ft 100Y MIXED AND MMACTIM IN T HE V . S h
ai�t wilf-motialarjEst, chief Eiitillaw&t
Cert Summary Page SLSB, LLC dba ST. LOUIS SCREW & BOLT
VETRO SITECFABR4CATCgRS LLC c C C CustomerPO 13928
Invoice No. D7120469 Invoice Date 12/11/17 Sales Order U61608
Cert No Inv Line No Item No Quarittity Lot No Heat
1;5750 60000 PACKINGSLIP 0 U61608
C Description: PACKING LIST Supplier: SLSB
136545
C
No PO
SLSB
70000 VDHGO50 2,000 16-04-025 10398430 SL81555
Description: 1/2(13)HVYHEXNUTA563-DHHDG Supplier: DECKER MANUFACTURING CORP.
I
0.
PACKING LIST
Carts With Shipment
D..b., if.
2017
From.
S-1d TO.' 66620
SLSB,LLC
METRO SITE FABRICATORS LLC
dba ST. LOUIS SCREW & BOLT
585 PRITCHETT RD. [INVOICING]
PO BOX 260
LULA, GA 30554
MADISON, IL 62060-0260
Phone: 800-237-7059 Fax: 314-389-7510
Phone: 706-335-7045
Sales Order No: U61608 Date: 12111/17
Fax: 770-869-7668
Sales Person: DREW BROCKMEYER
Picked By 141
is
Page I
Ship To.
RGA
METRO SITE FABRICATORS LLC
REQUIRED
180 INDUSTRIAL PARK BLVD
COMMERCE, GA 30529
FOR
RETURNS
Contact:
Phone; 770-869-7898
PO No.: 13928
Ship Terms: FREIGHT AS A LINE ITEM ON ORDER
Due Date: 12111117 VIA: ESTES EXPRESS LINES BL No.
Shipped With Sales Orders U61608
103313A Total Weight: 125 Comment I KEG
Tracking No.: 101-0492997
Item No.
Description
LIM Ordered
Shipped Backord Cont Skid Mfg Lot No. Job
ALWAYS USE BLUE WAXED HDG NUTS
TRACKING NUMBER MUST BE SENT TO acallahan@metrositelle.com
**HEXPORT CUSTOMER
LOAD ALL CERTS AND PACKING LISTS ONLINE
CERTS
MATERIAL CERTS 100% DOMESTIC
EACH 0
0
USA
PACKINGSILIP
PACKING LIST
EACH 0
0
VDHGO50
1/2(13) HVY HEX NUT A563-DH HDG
PCs 2,000
2,000 1 16-04-025
ALL CLAIMS MUST BE MADE WITHIN 10 DAYS - 10% OVERAGE ON SPECIAL ORDERS Buyer agrees to be bound by the sellers terms and wnditions of sale and credit.
0 IS
aCDECKER
SINCE 1027 runadeckernatcorn L9224
A117.0022IS
ST LOUIS SCREW & BOLT
2000A6CESSBLVD
MADISON, IL 62060
PRODUCT MATERIAL CERTIFICATION
P*4cd.z2-=7 &,xw Fm
FeirtlarY23,M17
CUSTOMER PART NUMBER: VDHG050 INVOICE: 129398
CUSTOMER P.O. NUMBER: SLB1555
LOTNUMBER: m-oiI.o2s DESCRIPTION: 112NC .018 HVY DH
DATE: Oct 1A-2015 QUANTITY; 3a,oao
HEATNUMM: 1039WO MATERtALSUPPLIEP, CHARTERSTEEL
MATERIAL- STEEL-CIO28
The ItEmswere Processed under the Decker Quality Manual. The current revision Is dated Ja" JZ 240os
NovvialdirVwaspeormed,
Tihis document accurately reprewftv8ILeS and statements providedi bYOtu 6WIlerS accredited testing facgily.
The original mela'luticaj test �eprt shag be retained on file byDECKER MANUFACTURING CORI?ORATION for
a period of not less than (10) y�
CHEMICAL ANALYSIS BY MATERIAL SUPPLIER
CARBON: 6170 PHOSPHOROUS: '0.008
MANGANESE: 0.770 SULFUR: 0.009
DECKER MANUFACTURING bORPOR-ATION
Russel L *iLson
QualllyAsunnce Manager
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INsptrhbNrtuTDAeH(SI-- I —a-;/-'7'-.
Rocmpu�-NRC-1
7
REOUIRV
INPEMON ITEST.PkSm�TS.-
UNITOrPMEASURE�IFNT:. I=
inclMduai c�r4 ieadi
0
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AND
4twho ab -thific,labi:1.1-
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CHARTER
STEEL
A�O
Ideltad In URA Manufactumd in USA
Dec ' ker Manufacluring CDrp.
703 N. Clark SL
AJblon,MI-49224
0 EMAIL
CHARTER STEEL TEST REPORT
�1604—
N.N.
49707
C.'sm,
I; mrsalmo r
.7971026
WaAS FGFRm I
tiffij) 631D I
511841
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ad
A&I
REDUCTIOU RATIO-61:1
T 11,111111,111W 1:11MMi IN
71 kk.vwe
ROCK114FULB(IIIISM 2 WT11% LIM Vawe It
�c..�:
'dvu I UFA
The folloming 0 port: I
I InITUNIOd States Meeting DFARS
"al
1. Except as natedft: ",teel
cOmpliwnce, LEEDS oarapfi�ncc, REACH compliance, ROHS.WrEE compliance, and CwMct Material R
2. Mercury was not used duft the manufacture of this Product, nor was the steel corner, t estrictions.
processing. Inated vvftb mercury during -
3. Unless directed by the cusionaer, tham am no urelds In any of the cons produced for this order,
4- The lsbwkufY that 9eherated the analytical or test maults can be IdenUfled by theforowirin ke,
Corkincate
Lab
Number
Code
Laboratory
t d
0358-01
7388
'U
C
�SM lCharter Slael Megirm DwxF
V
16 , C ..PMg5KOaa.iaulMUO,WI5308D
D3SS.02
all'
81,1
C
CSbw lunartOr Wool Rolling? Processing Division
I Ma Co'd SprbVs Road, Saukville, W1 Ssubu
C css
035M
122M633
CSFP
lCharterSteelt
�10�5,1n, �D,"on
5255 US 9 Sun,,OH 434457
�04
55
1255144
CS
ChartarSted uwwand
C, eZ
Fva-y-23.
L Ulm H
UP
94uu F- 4UM 5L, C I" Hetbhi, 0H44j26.I0D4
a a.
1 12 OH 4126.1M
[CSCCMRI
, , 4
-J�Evbccr�ihecledtq6t
pe�jf&mWby labomtory not in Charter Steel system
-1 - --.1 U. ..luV-zw0mPGr1Omwd accondingto Via latest mWsj,,, of the
sPecificalions listed belaN, as noted in the Charter Steel Labnm� Mm?� 11?� -i,
Pecificatlons
CSSR/
CSCM!
$by Aftagilrsis
ASTME415:ASTM 101v
CSSM
CSSP
CSFP
CsCR
etch
ASTM E381
X
X,
X
enoblifty FJo��h-yj
ASTM A255; SAE JOB: JIS G0661
X
X
'Sit, I
STM El 12
X
X
X
X
ge Test
TM EB: ASM A370
X
X
Rockwoul Flardness
ASTAI EIS, ASTM A370
X
X
X
X
(sphervidiwon)
ASTMABS2
X
X
lineWoncontmi IiCiiii:::i i � !I;;:
: �: le; , ::I
�WT—M E45
X
X
,uecarouncation tASTM
E1077
"X
A I
X I
X
— u=my me American ASSOCiallori for Lzb6mtojy Acredlbalioh
Wst.m.GUftS BnOcl2tOd VAlh a ChsrWrSt&oI ]a bdrita ryr tnat ap p a w on
the front Of this report it shy. wera paic�md ..,Odg
Omrodittod byA2.LA. - to dOWmented VOceduMs developed by Charter Steel and &a not
6. The test resins on the front Of this report are the true Values measured on the swr.Mas taKein from the production 101. They
do not apply to any other sample.
7. This Met report cannot be reproduced or d1strib"d except in fig wittout the Written PefinkslOn Of Charter Sted. The primary
customer MMOSS name and addM39 8W3ron the front ofthis forrin may mprudieg this stre SUN ng
rostrictiom to Pon . ect to the foUaM
• [IffmybeftMbut.OdMIYIOtheircugldfNrs
• Both sides of al Mes, must be reproduced In fun
This cartification is9hren stkiect to,tha t�mm and conditions of. sale provided In Charter Steers acknowledgement
(d9sl6runed birourSO-s0rder number) to the CUStOO18ft Purchase order. Both Order numberb appear on the ftnt page or
ft Report.
S. Mvere the cwtorner ties Provided a specification, the results on the front of,this test report conform to that specticeiton
unless othervAse noted on M test mpo.,L
Twins "WM�r
'Page 2 012
INDIANAALVANIZING, LLC
Hot-DIpGalvaniziag
S1702 Lovejoy Dr.
KddleburyiN,46540
phme-'57+1122-9102 FOX: 574-822-9106
Customer
Decker Manufacturing Corporation
703 North Clark Street
Albion M 49224
Hot -Dip GalvartUing Certification
Pa 2B39
DATE:
1/19,'2017
Indiana Galvanizing Certifies d1al samillm rcllygatinag liked 101(s) have been tested and inspected as
requited by applicable specifications. The results Of Us !=P=t!On and testiflg demonstnucs that the
rewirtments & ASTM FM29. including the requircrianiq ASTM rA 15i that an safeninced 41hin the
specification, have bcm MCI and ben beet Balvanized in MiWelt Ury, Indiam of the United States of
America, Indiana Wmiffing LEC is ROHS c"lisint.
Kittle Tempentum (Mum be bww"n B15 and 850 DVccs rhmn&it) 340
Mil Readings
I Putt Numb"
5-1 —Kumb�r
—Low
Avem, -
NUITed
035-1031-26
17-5"0)
290
2A&
2.60
x
033-08DH-26
16-04-024
3.8D
140
3.10
033-ODH-26
16-04-02S
---'r�52'M9
3.60
2-80
—3—
.20
x
033-12DH.26,
39D
2.60
3-25
x
026-1608-26
17-44-001
—IOD
--160—
—2.00
2.00
x
02&1608-26
17-44-002
2-30
2-40
—X
Quality Managor w Anignee
0--- 1
AAW\
VA
echnicai Cendication Docurnmt
Sales Order. Iowa
Certification Date: 21312017
Customer Name: DECKER MANUFACTURING CORPORATION
703 NORTH CLARK STREET
ALEIION� MI 49224
Part Number: 033-0111111.29
Lot Number 16-04-025
PO Number: 29s4
Container ID; 0
Customer Shipper Number.
Part - Quant-*(Ibs): 2834
Part Quantity(ea): a
Process S pecification: TOO BLUE PROCESSED IN THE US.
Tw� is to wtity that UK abM PaM V�ere prMwed Y" the 96iddho or the apprable sped
. . f1m3row dev9ned by the pethaso ortser.
Proom tM re�ftsar eavMzt1eforexardnatkncrrEWWUCbm' uponm quest
-Testinp Technology
Test Wthad
Requirement
PCs.
Test Results
Appearvirice
Visual
Uniform
I
PASS
Coating Thicknow
ASTM D499(09)
Typical 12r2O urn
5
PASS (Surrogate)
Salt Spray,
ASTM B-117 (11)
336 His No Red Rust
3
PASS (Surrogate)
Adhesion
ASTM D3359fO-9)
Metfiod-A
No Flake or Peel
1
PASS (Surrogate)
LABORATORY AM, B)r.
ACCREDITATIIO�
0
n Paulzone,
BUREAU
ACCREDITED OSOIIEC17025 Technicad 111-44,
CWftM0L210G-jT*SwQ ,,a Pas! I of I
MM-0145
CNIC STEEL SOUTH CAROLINA
310 New State Read
C,;�CeS0329033370(4
CMC -7
4
ERIES' BPS
CERTIFIED M ILL TEST REPORT
For additional, copies call
EID&437-21227.
W8Ltfcfebv coilifir that the test re3ults pmented.here
are accurate wd.conform in the reported grade specification
Rjik4.j. 6*
Wichand S. Ray - CMC Steel SC
HEAT NO.:206034'1
S�
Siskin Ateall & Sujjpf�
S
Siskin Steel SplftnburgCPU
Defivaryff: 82105268
SECTIONi ANe 1314 X I 314x3116
20*0"
0
111
Bom is21479
A30182950
L
1901 Rivarhant Pkvij
I
3101YOWuSiateRd
CUSTPO#:V,57809-S.
GRADE: ASTM A36-141A52S1-14,GrS0.
I
Chattanooga TN1
PfCayed'-SC
CUST PIN: 121602:
ROLL DATE:
Ud'3740&1037
U9 29033-3704
DLVRY LBS /MEAT. 4BIBL 000 US
MELT DATE: 08/03/2017
T
4237663671
T
80 1 3036 L 3 1 700
DLVRY PCS I HEAT:11 6 FA
Cart. No 8�1652 Bi I b603410474
C1
423766273!4
Characteristic
Value
Chamotevistle Value
Chametarristic Value
0
0.13%
Mangation Gotho Lgth MI I
SIN
Mn
0,64%
Yield to tensile rate toutl
0 L
.74
P
0.012%
viald Strength test 2
54.9kal
5
9.02591,
Tensile Strength test 2
74.0ksi
Si'
0.20%
Elongation tet;12
27%
Cis
M31%
Elchgatim dage 1.9tihIest 2
'BIN
Cr
0.13%
Yield to tensile ratio tcat2
0.74
W,
0.099�
O+(Mn1B)
0.24%
Me
0.033%
v
0.000%
Cb
0.010%
Sn
0.009%
no Faftwina Is true of the ntnerld roof�sffrdot by thk MITR:
At
0.00D%
Ala?&Mivf&RykHkd
m
0.001%
- 700% mefteded mhlirdih th, dSA
N
0.0032%
'FVf02"-2*Q4'3. I cvw1,,%t
GarbonliqA529
0.33%
,-contaws ne
Yield Strength test 1
55.01:61
Manaimumcf,6: accodance , wMthebresti,mbn
Tervaila Strength test I
73.8kai
of theadant , quaUrvirientral
Elongation test 1
27%
W"WIhm 23CfR635.4 10
A ' LSO MEETS ASTM GRADEA36 REV-03A, A529 0111,50;AS72-2015 (1111.50,A7090FLIG. A709611.90,A992, AASHTO GRADEM270 GA.36, M270GR.60.,CSA,G40.21-04 GRAD
44W, GOWASMSSA-36 2008AADDiND A.
06113/2017,09:69;25
i�
Pago 1 OF I
8
17
Chemical Analysis
HentNumber C Mn r
12369 0.660 0.630 0.010 0.019
purchass Date Quantity
OrderNumbor Part Description Shipped shippa
3LB4194 j/2"RBa U%V 10601-IOT DIP GALV 1 ItIO12017 30,000
We hereby caitif� that the subject parts confbmi to the requirements of the nVicable specification
indicated fol. Cie subject parts and am incomplete conformallea to ASME BIB-21, - Wehcrcby
ccrdf� that the subject parts wore hardened to RC 3BA6. Wchcreb Celt7 that the subject palls wore
liotd�gaivaiilzedinnocardanoe%vithspftiflcntionASMA153CEASS
e hereby certify flint all statutcxy requirements as to American P"uctlon and Labor Stnndards and all
conditions of purchase applicable to the transaction have boon compiled with and that the subject parts were
manullactured In the U.S.A.
Truly yours,
Wrotighl Wasber Mfg., Inc.
Paul Schacrer
Q.Q Manager
T, 10 =��
sworn gild subscribed befolromoon Novembor2O,2017
My commission explics April 24,2021
(W��LOCKSF
ASIVOO
WR UGJJT%1 AS HIRMIMINALUSE! 00080=1013109
1901 CHICORY RD. - MOUNT PLEASANT, WI 53403 1 PHONE (262) 554-9550 ' FAX (262) 554-95S4
VISIT OUR WERSIVE! www-WfOughtwasher-com
a
a
I
I
Cortifled Material Test Report
Sterling Steel Companyj LLC
1011 Ave K
Sterling, IL 01031
Phone: (6%) 648-7000
Fax: (816) 64&7019
BILL TO Mora Steel Cc SHIP TO dome
761 W Inclarm
Kou% In
Date =01207
PO 0000008265
13l)
Item Derediptlan
ROD HC 114 130
"WPIRES: 6-30-2019
NVLAP ACCREDITED LAS CODE. 200722.0
TEST CONFORM TO ASTM WS
jHeotNQ.
I C
I Mn_j
P
1 8
1 61 j
Our
IN I
Cr
I No
I Sn
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V
13
Nb j;.CW4!;
N
223591
0.551
0.6310,02010.0191
0.201
M2010-07310.0831
0.0181U.009910.001910.0000
e,GRQ0
Owl
0
am
5FEMALIESTWULTS
ASTM Grain Sin P U
ADDITIONAL COMMENTS
'rho use oftho term "NVLAP"ImrAloo no connection orquaranbur of the produetbyNVLAP.
Thlt certified test report has been delivered lo a consignee for malaria! purchased from STERUNG STEM CO., I-W. To
AVOld the possibility of Its miuso, on the ro-cleffirary, a( this "it to a third perty It MUSI be FOCOFtigOd bY;Lnd Under (he name
of sudi consignee.
No mercusy, lead, cadoduaij radfule, or alpha cordaInIng matellal We hereby cortily that the aboVe tact IGBWtB ore
orequIpinont to used ordelbarblety added In the proddotlan rapm"clegya, oftho material Idenlifled AbM,
61thisatwL NowddorW4ldrcP;dMwwoF9dofflWon
Oft material. Wa stact Is W,% M=Wa Ara Furnuce
Molted,Cwf, and Railed In that U.GA
Nichols W-7044
CrRY 0 519
I
INSKCTM1 CMIFMTE
PERIT SIM-M
m W. 11MM MET
LEMT & MATT INC.
WAS IN 46541
217-766-Ml RY,
CIATUPA NO"r "M
MFOW ME DROUM WO NO INC
ADM: 2100 8 MY By
ME 2
;_ 'V
m ORDER NUPW ... 4 ... 15018
IRILM CUMIROL llium'.x 2094
WMX P.D. IM
09PPIN DAIL., OU21/l/
TOTAL Iffis.... I
AITLVIM [fir AM N.C. MI C1060
BE M MIED IN USA
Iff W H.C. .174 1060
KELM & HANFACTURED USA
AMYSIO
PEAT
DEMPTIO11 s DIAMER I
FAR
OF WA
r NWSERs
WE & TVE WK
Wall
(MM) to= -.WW
M AU tSILI MJPFFA :ALOM
z GRADE i
Mo IMM
MLY Elam W11huMm I
12311
W 0 N.C. .174 1060
.61 r .65
1 .00? . .011 r .21 1 .10 1 .00,
9MR2 00.174 Mi.17420 c
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TAM.
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KOM OF USA. 00 1(1 O.S.ft.
J.2359
MT N#( II.C. .141 C1060
1 .55 1 .63
.010 1 .019 c .20 1 .20 1 .00191
OAUM 00.141, MINt.142700 j
OD174 t
.0DOODO 1 .00101 .08
1 0101 -07 1 -00751 -00001-
IN
Mt 12T AM HD M,1420t
87040.
OM a
imv
PMW OF LIM. DRAW III U.S.A.
12359
BRT W HX. .174 1060
1 55 z .65
.01D a .017 1 .20 .20 . OMPE
mm- 00.174 HIN1.17MO I
M095 -
.000000 a .0020. .09
.010 : .0 1 40751 .0000.
In lYfEt MY 10 HC Wi.VM I B40W I -DOM
123W Fiffim w Um. ORMA IN U.S.A.
This certified tL-t report hAs bm delivered Lo a migm 4or 0810r;61 Purchased from Iml SIM-
To avoid the posribility of its Pusum, an the rE-dalivery of this report to a third party it "t te rKertif sod by and
under the mark of surb consignee.
The chmicall physical, or wthantral Wets reported are correct as contained in the tecards of the Corporation,
Signed
ED End of ftmeal m
ROGRIS 320TINMAS HNCM
CERTMICATE, OF . COrLLINCIVM..
IVOR HOT DIP.GALVAMMG
CUSTOMR: Wa��Tx&smhag- INC,
IDATM 25,2017
Pool 3a935
ROG M, 01WERM 137536
DISCRIPTIOM (,9690D—.507m-.125TM1/2"gM
VMCH: 018169
COATING THICKNESS
Horm
OALYAMONO
TAO# gm B "0 LOW
427389 58,217 1.30 1.30 4.00
WE HEREBY CBRTJFY THAT THEABOVP SIMAND LOTMMERWHICH WAS HOr
DIP GALVANIM IN OUR PLANT MRM TEE SPEMICATIONS Or AMM Al 53,
CLASS D.
THE ABOVE SMS AND LOTNUMMS COIRLYWUHTHE MATING,
WORXMANSW� FINISH, AND AMAWOR REQUnMMM OF XFIM P2329.
THE HOTDIP GALVANIENGIS ROHS COMPLIANT. THE GAtVANMO PROCESS
WAS CONDUCTED IN A T"BRATUX9 RANGE OF 93OF TO $SOP.
TMS PRODUCT WAS GALVANMD 1NX0CMRD, IL USA,
ROCERS BROMRS INC. I
Lorraine P. Shelbume
Vice President
LPS,pd
SUBSCRIBED AND SWORN
BEFORE METHIS 25TH DAY
OFJULY2017,AD
PU13LIC
Maep.9 GRoTHER% wchim FJBHWAUXEE=;��,AQ�6KEOiWLLINOMMI04-5197 PHONE:6161MM32 PM M/0864706
I &MAIUrm SeMnot
M E T F z 0"IF
Site
To -77—
American Tower Corporation
PO Box 2DO9
Woburn, MA 01801
United states of America
C- 7Ai-Q9A.7A4qan
Metro Site Fabricators. LLC
100 industrial Palk Boulevard
commerce, CIA 30529
United States of America
Fft 706-335-7045
Fax: 706-335-7056
F-77 Pack LI St Data: 01-Feb-18
Number: 18215 Pack List
Ship To
Jerry Gore
Westbrook Towem
14531 SE 6th Lane
Wimaton, FL 32696
United States of America
Fix 677-7tv-Zw�
I
ship via
Terms
Net 60 Days
Quantity Descriallon
1 part RELAY TOWER. FL 6080 Rev:
as PROVIDE MATERIALS
iob�. 15234-SE
po: 487042 - J. GORE Line*. 1-
-------------
- ---- ----------------------
job Bill of Materials
Job job Pao Numbef
m2terin peardolo
msoi-sM176-A325-HD G IW X j.W BOLT A326-HDG
Make 0
Oly Pe
57.00
15234-SE
111801-500-2"2"D13 ire X 21 BOLT A325-HDG
19.00
i5234-SE
MSOI-500-LKW.HIDG I&I LOCK WASHER HOG
76.00
jeZi4ZE
MSCI-50D.SFLW-HDG 112 STR FLAT WASHER F436-1 HDG
70.00
15234-SE
mi-600-SHNN-1013 jj2 STR KVy HXf4T A563-DH HOG
76.00
16234-SE
LI-314 X 1,V4 X 3116, T-W
12
15234-r.Ei mo-i
12
15234-SE2 6050-2
LI-304 X I-W4 X 3M6.3-W
16234-SE3 608"
131. 114 X 6-3A X 6-3W
6
poN - 211=18 1;46:57 PM)
aga 0,
BILL OF MATERIALS
ouAuTiTy
REQUIRED
ouArfnTy
PROVIDED
PART I
NUMBER
OESCRIPTION
LENGTH
SHEET LIST
PART
WEIGHT
WEIGHT
�(lb)
NOTES
OAGONAL BACKTO-BACK MA�Al. & KARDNAFRE
—X3flB
ATC TO�R SMVICES, LLC
12
12
�l I
L 1 NW'X FM
3.6-
A-2. �l
7.8
m
12
12
�2
L 1 WC X 1 w xxie.
7.6'
A-2, �l
7.8
94
6.
6
sos�
KIXX6Xe
U-8 3W
A-2, �l
3.4
20
54
57
—
SOLT, 1170ASTMA325
1314"
—
--
��FWIGALVANIZBD
1 B
19
—
BOLT. 100 ASTMA325
1.
��PW/�LVANMM
5080
REiAY TOWER
FLORIDA
BILL OF MATERIALS
TOTAL WEIGHT (lb)
208
PAGE 1 OF I
0 0
COLD GALVANIZING VERIFICATION