Sample Record for 2020-07-15-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214601 DEA: 041J5694 EFIS: 0419000313
QA Service Level: 1
DIST-CO-RTE-PM: 04-SM-101-0.0/21.8
Work Description: San Mateo US 101 Express Lanes North
Location Description:
Contractor Name: KIEWIT INFRASTRUCTURE COMPANY
Contractor Address: 1301 SHOREWAY RD, SUITE 275, BELMONT, CA 94402
Resident Engineer: Douglas Inori Structure Rep.: Tyler Pinell
Sample Information
DIME Sample ID: 2020-07-15-2
TL Number from the TL Form:
Sample Submitted By Organization: CT METS QASI - Los Angeles Design Build Field Laboratory
Sample Organization Contact: (619) 204-7248
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 07/15/2020
Date that the sample was received by the laboratory/organization performing the testing: 07/15/2020
The quantity of what the sample constitutes: 7 total 82 in total
A brief description of the sample: 1/2"x 2-3/4" HH A325 Bolt
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Structural and Steel Products
Material Information
Rocap Number(s): 060920AR
Heat Number(s): 365604A
Nut Mfg. Lot Number(s): 405806A
Washer Mfg. Lot Number(s): 317843
Bolt Specification: ASTM A325
Bolt Length(s): 2-3/4"
Nut Specification: ASTM A563
Washer Specification: ASTM F436
Finish: Mech.Zinc Galv. ASTM B695
Diameter/Size: 1/2"x 2-3/4"
Bolt Mfg. Lot Number: 400458A
Rocap Test Requirement(s): 060920AR
Lubricant Requirements(s):
Test Results
