Sample Record for 2018-07-02-7
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
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, Benicia, CA 94510
Resident Engineer: Saeed Safi Structure Rep.: Dante G Padiernos
Sample Information
DIME Sample ID: 2018-07-02-7
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
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:
The fabricator/manufacturer/facility name: Ulmer Industries
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):
Test Results
