Sample Record for 2025-07-07-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994828 DEA: 043Y4104 EFIS: 0423000232
QA Service Level: 1
DIST-CO-RTE-PM: 04-CC,SM-680-25.04/25.46, VAR/VAR
Work Description: Paint removal and non-destructive testing (NDT) on butt weld connections on T1 type steel in fracture critical members of three distinct existing toll bridge.
Location Description: Carquinez Bridge Overhead (Br. No. 23-0015R), Benicia-Martinez Bridge Overhead (Br. No. 28-0153L), and San Mateo-Hayward Bridge (Br. No. 35-0054). County = SM,CC,SOL. Route = 680,80,92.
Contractor Name: Golden State Bridge Inc.
Contractor Address: Unknown
Resident Engineer: Kingston Atako Structure Rep.: Angelo Perez
Sample Information
DIME Sample ID: 2025-07-07-2
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: 07/07/2025
Date that the sample was received by the laboratory/organization performing the testing: 07/07/2025
The quantity of what the sample constitutes: 254
A brief description of the sample: A325 HDG Rocap Assembiy
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Bay Bolt Oakland, Ca
Material Information
Rocap Number(s):
Heat Number(s):
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s):
Bolt Specification: A325
Bolt Length(s): 4
Nut Specification: ASTM A563
Washer Specification: ASTM F436
Finish:
Diameter/Size:
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):
Washer Inner Diameter(s):
Test Results
