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Sample Record for 2020-11-18-2

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: Barrier modifications, overhead signs, freeway lighting and electronic toll system components
Location Description: SANTA CLARA AND SAN MATEO COUNTIES FROM 0.3 MILE NORTH OF SAN ANTONIO ROAD TO 0.3 MILE SOUTH OF GRAND AVENUE INTERCHANGE
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: 2020-11-18-2
TL Number from the TL Form: TL-102
Sample Submitted By Organization: CT QASI - Bay Area Field Laboratory
Sample Organization Contact: (707) 649-5453
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 11/18/2020
Date that the sample was received by the laboratory/organization performing the testing: 11/18/2020
The quantity of what the sample constitutes: 14
A brief description of the sample: 1/2"x1-1/4" A325 HDG Bolts
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name: OHSS S63
The fabricator/manufacturer/facility name: Structural and Steel Products

Material Information

Rocap Number(s): 368068AR
Heat Number(s): NF15103239
Nut Mfg. Lot Number(s): N/A
Washer Mfg. Lot Number(s): N/A
Bolt Specification: ASTM A325
Bolt Length(s): 1-1/4"
Nut Specification: N/A
Washer Specification: N/A
Finish: Mech Galv-B695
Diameter/Size: 1/2"x 1-1/4"
Bolt Mfg. Lot Number: N/A
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Results

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.