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Sample Record for 2019-11-13-12

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

Project Information

Project ID: 214399 DEA: 044Q3404 EFIS: 0419000383 QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN-580-1.3, 1.30
Work Description: Near San Quentin, in the Richmond-San Rafael Bridge, heat straightening truss chords
Location Description: Near San Quentin, in the Richmond-San Rafael Bridge
Contractor Name: O.C. JONES & SONS, INC.
Contractor Address: 1520 Fourth St., Berkeley, CA 94710
Resident Engineer: Bezhad Halali Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-11-13-12
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 11/13/2019
Date that the sample was received by the laboratory/organization performing the testing: 11/19/2019
The quantity of what the sample constitutes: 55 assemblies
A brief description of the sample: A325 HDGalv Fastener assemblies
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name: unknown
The fabricator/manufacturer/facility name: Bay Bolt

Material Information

Rocap Number(s): 6693-01
Heat Number(s): DL17103751
Nut Mfg. Lot Number(s): 413071C
Washer Mfg. Lot Number(s): 0818-925
Bolt Specification: ASTM F3125 A325 Type 1 HDGalv
Bolt Length(s): 1 3/4"
Nut Specification: A563 gr DH
Washer Specification: F436 HDG
Finish: Hot Dip Galv.
Diameter/Size: 3/4"
Bolt Mfg. Lot Number: 396988B
Rocap Test Requirement(s): yes
Lubricant Requirements(s): yes

Test Results