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Sample Record for 2020-08-03-3


Project Information

Project ID: 212501 DEA: 022E4804 EFIS: 0200000586 QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-96,263-103.1/103.6,56.8/57.2
Work Description: BRIDGE REPLACEMENT
Location Description: SISKIYOU COUNTY ABOUT 8 MILES NORTH OF YREKA ON ROUTE 96 FROM 0.5 MILE WEST TO 0.2 MILE EAST OF ROUTE 263 AND ON ROUTE 263 FROM 0.3 MILE NORTH OF SHASTA RIVER BRIDGE #02-0014 TO ROUTE 96
Contractor Name: Golden State Bridge Contractor Address: 3701 Mallard Drive
Resident Engineer: Nicole Mallory Structure Rep.: O'Sullevan, Andy

Sample Information

DIME Sample ID: 2020-08-03-3
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: 08/03/2020
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 87/87/174
A brief description of the sample: 1/2" x 3-1/2" A325 bolts, 1/2" A563-DH nuts and 1/2" F436 washers
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

Rocap Number(s): TT0131087
Heat Number(s): bolts - 20495460, nuts - 20650010, washers - 190394
Nut Mfg. Lot Number(s): L511Q1
Washer Mfg. Lot Number(s): 957-190394
Bolt Specification: A325
Bolt Length(s): 3-1/2"
Nut Specification: A563-DH
Washer Specification: F436
Finish: HDG - all
Diameter/Size: 1/2"
Bolt Mfg. Lot Number: G9825
Rocap Test Requirement(s): Yes
Lubricant Requirements(s): none