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

Sample Record for 2019-09-27-3


Project Information

Project ID: 214274 DEA: 010J7304 EFIS: 0119000082 MINOR: 01A2002 QA Service Level: 1
DIST-CO-RTE-PM: 01-MEN-1-18.0/23.0
Work Description:
Location Description:
Contractor Name: Contractor Address:
Resident Engineer: Roozbeh Hadipour Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-09-27-3
TL Number from the TL Form:
Sample Submitted By Organization: Caltrans Vallejo Field Laboratory
Sample Organization Contact: (510) 774-6009
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 09/27/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 22
A brief description of the sample: A325 Bolt,nut and washer
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier: 23-men
Structure name:

Material Information

Rocap Number(s): 4881-01
Heat Number(s): DL17101274
Nut Mfg. Lot Number(s): DL1710127401
Washer Mfg. Lot Number(s): 0619-188
Bolt Specification: A325
Bolt Length(s): 2"
Nut Specification: 1045L
Washer Specification: F436 HDG
Finish: HDG
Diameter/Size: 1-1/8"
Bolt Mfg. Lot Number: 160850A
Rocap Test Requirement(s): A325
Lubricant Requirements(s): Nut only