Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2022-03-18-3

Project Information

Project IdentifiersProject ID: 215371
DEA: 042W1204
EFIS: 0421000139
DIST-CO-RTE-PM04-CC,CC/MRN-580-6.9/7.8, 6.9, 7.8, 02, 5
Award Date01/11/2020
Closeout Date09/06/2022
Work DescriptionREPLACEMENT OF GUSSET PLATES AT VARIOUS LOCATIONS
Location DescriptionRichmond San Rafael Bridge
QA Service Level1 (Verified on 12/14/2020)

Sample Information

Sample Taken Date03/18/2022 Sample Unique Key3
Date that the sample was received by the laboratory/organization performing the testingNot set Sample typeQuality Assurance
A brief description of the sampleAll-Thread Rod The quantity of what the sample constitutes24
From where was the sample collectedDistributor First name of sampler or witnessed byBrian
Last name of sampler or witnessed byMurray Title of samplerQA Inspector
Telephone number of sampler213 435 4055 Laboratory sample identification
Linked DIME Sample ID The fabricator/manufacturer/facility nameLiberty Bolt
Transportation Laboratory (TL) Number Inspector Lot Number from the Transportation Laboratory (TL) FormL140-040-22
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)n/a
Heat Number(s)11722380 Nut Mfg. Lot Number(s)n/a
Washer Mfg. Lot Number(s)n/a Bolt SpecificationASTM A354-BD
Bolt Length(s)71" Nut Specificationn/a
Washer Specificationn/a FinishHot Dipped Galvanized
Diameter/Size1 1/8" Bolt Mfg. Lot Numbern/a
Rocap Test Requirement(s) Lubricant Requirements(s)
Washer Inner Diameter(s)

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedDate AddedVerified?Release DateTest CommentsPrivacy LevelActions
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