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Sample Record for 2018-08-17-2

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 212956 DEA: 080R3404 EFIS: 0812000072 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-38-30.9
Work Description: BRIDGE REHABILITATION AND UPGRADE BRIDGE RAILING TO STANDARDS
Location Description: SAN BERNARDINO COUNTY NEAR ANGELUS OAKS AT SANTA ANA RIVER BRIDGERAM
Contractor Name: RSB GROUP, INC.
Contractor Address: 20331 Lake Forest Dr, Lake Forest, CA 92630
Resident Engineer: Ken Tran Structure Rep.: Sylvia Stracner

Sample Information

DIME Sample ID: 2018-08-17-2
TL Number from the TL Form: Unknown
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: 08/17/2018
Date that the sample was received by the laboratory/organization performing the testing: 08/17/2018
The quantity of what the sample constitutes: 3
A brief description of the sample: A325 HDG Rocap Assembiy
From where was the sample collected: Fabricator
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CFabrication

Material Information

Rocap Number(s):
Heat Number(s): 3072436
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s):
Bolt Specification: A325
Bolt Length(s): 4-5/16"
Nut Specification: A563
Washer Specification: F436
Finish: Galvanized
Diameter/Size: 3/4
Bolt Mfg. Lot Number: 51790-2
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Results