Sample Record for 2026-08-11-54
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1001075 DEA: 040W0304 EFIS: 0420000164
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-580-0.02/6.3
Work Description: Replace existing tolling structure with open road tolling (ORT) system at the Richmond-San Rafael.
Location Description:
Contractor Name: FLATIRON WEST INC.
Contractor Address: 1200 Concord Ave Suite 465, Concord, CA 94520
Resident Engineer: William Sommer Structure Rep.: Eric Racadag
Sample Information
DIME Sample ID: 2026-08-11-54
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 08/11/2026
Date that the sample was received by the laboratory/organization performing the testing: 08/19/2026
The quantity of what the sample constitutes: 6
A brief description of the sample: 3/4 nuts
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: XKT Engineering
Material Information
Rocap Number(s): W000339200
Heat Number(s): 1000134536
Nut Mfg. Lot Number(s): W000319916
Washer Mfg. Lot Number(s): E9348
Bolt Specification: ASTM A325
Bolt Length(s): 2-1/4
Nut Specification: ASTM A563
Washer Specification: ASTM F436
Finish: HDG
Diameter/Size: 3/4
Bolt Mfg. Lot Number: W000339200
Rocap Test Requirement(s): W000339200
Lubricant Requirements(s): wax
Washer Inner Diameter(s): 000
Test Results
