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Sample Record for 2018-07-02-7


Project Information

Project ID: 210631 DEA: 040J2904 EFIS: 0413000429 QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-61-18.5
Work Description: SPOT BLAST CLEAN, PAINT STEEL ELEMENTS, AND PERFORM WORK IN BUILDING.
Location Description: ALAMEDA COUNTY IN ALAMEDA AT SAN LEANDRO BAY BRIDGE AND AT SAN LEANDRO BAY BIKE BRIDGE
Contractor Name: AMERICAN CIVIL CONSTRUCTORS WEST COAST LLC Contractor Address: 2990 Bay Vista Ct
Resident Engineer: Saeed Safi Structure Rep.: Padiernos, Dante G

Sample Information

DIME Sample ID: 2018-07-02-7
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Los Angeles Field Laboratory
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 07/02/2018
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 77
A brief description of the sample: HS ASTM A 325 Bolts
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

Rocap Number(s):
Heat Number(s): 100791539, 10543000, 10790391
Nut Mfg. Lot Number(s): 28153-188245
Washer Mfg. Lot Number(s): 308246
Bolt Specification: ASTM A325
Bolt Length(s): 2", 2.25", 2.5"
Nut Specification: ASTM A563
Washer Specification: ASTM F436
Finish: Galvanized
Diameter/Size: 3/4"
Bolt Mfg. Lot Number: BG1201, BG1227, BG1161
Rocap Test Requirement(s):
Lubricant Requirements(s):