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

Sample Record for 2018-12-28-2


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
Resident Engineer: Structure Rep.: ,

Sample Information

DIME Sample ID: 2018-12-28-2
TL Number from the TL Form:
Sample Submitted By Organization: CT - Unassigned/General Field Laboratory
Sample Organization Contact: (510) 385-8178
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: 135
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:

Material Information

Rocap Number(s): 29042-10558410-CALTRANS
Heat Number(s):
Nut Mfg. Lot Number(s): 29076-6214709002
Washer Mfg. Lot Number(s): D6240
Bolt Specification: F3125
Bolt Length(s):
Nut Specification: A563 DH
Washer Specification: F436
Finish:
Diameter/Size:
Bolt Mfg. Lot Number: 29042-10554810
Rocap Test Requirement(s):
Lubricant Requirements(s):