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Sample Record for 2018-12-28-1

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

Project Information

Project ID: 208945 DEA: 07288604 EFIS: 0700021080 COOP: 074663 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-710-6.0-9.4
Work Description: Gerald Desmond Bridge Replacement - A Design Build project. IQA samples will be selected by Port/Caltrans representatives and sent to Translab for testing.
Location Description: Port of Long Beach (District 7)
Contractor Name: Shimmick/FCC/Impregilo (SFI) JV
Contractor Address: 11 Golden Shore, Suite 330, Long Beach, CA 90802
Resident Engineer: Structure Rep.:

Sample Information

DIME Sample ID: 2018-12-28-1
TL Number from the TL Form:
Sample Submitted By Organization: CT - Unassigned/General Field Laboratory
Sample Organization Contact: 5625005861
Type of Sample: Independent Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 12/28/2018
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 143
A brief description of the sample: F3125 GR A325 Fastener Assembly
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Unytite Inc

Material Information

Rocap Number(s): 28054-10537450-CALTRANS
Heat Number(s):
Nut Mfg. Lot Number(s): 28125-6214552205
Washer Mfg. Lot Number(s): D4996
Bolt Specification: F3125
Bolt Length(s):
Nut Specification: A563 DH
Washer Specification: F436
Bolt Mfg. Lot Number: 28054-10537450
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Results