Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
DEA: No Project
QA Service Level:
DIST-CO-RTE-PM: ---
Work Description: Special project identifier for material not associated with a project
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2019-08-30-11
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (530) 329-6527
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 08/30/2019
Date that the sample was received by the laboratory/organization performing the testing: 09/11/2019
The quantity of what the sample constitutes: 5
A brief description of the sample: A325 Bolts
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Ameron International
Rocap Number(s):
Heat Number(s): 3086601
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s):
Bolt Specification: F3125 A325
Bolt Length(s): Unknown
Nut Specification: NA
Washer Specification: NA
Finish: F2329
Diameter/Size: 1.5"
Bolt Mfg. Lot Number: 56102-1
Rocap Test Requirement(s):
Lubricant Requirements(s):
