Sample Record for 2022-02-04-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 215255 DEA: 040A7714 EFIS: 0420000287
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-80-6.4-6.6
Work Description: CONSTRUCT PEDESTRIAN OVERCROSSING BRIDGE AND RETAINING WALLS. GILMAN INTERCHANGE IMPROVEMENTS
Location Description: ALAMEDA COUNTY IN BERKELEY FROM 0.6 MILE NORTH OF UNIVERSITY AVENUE OVERCROSSING TO 0.1 MILE SOUTH OF GILMAN STREET UNDERCROSSING
Contractor Name: Golden State Bridge
Contractor Address: 3701 Mallard Drive, Benicia, CA 94510
Resident Engineer: Rebecca Perng Structure Rep.: Eric Urmeneta
Sample Information
DIME Sample ID: 2022-02-04-2
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 Control
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 02/04/2022
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 64
A brief description of the sample: 1-1/2x80" A354 GR BC HDG
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name: Gilman Street Bridge
The fabricator/manufacturer/facility name: Portland Bolt - Oregon
Material Information
Rocap Number(s):
Heat Number(s): 20743200, 201522, 41635670
Nut Mfg. Lot Number(s): DECR
Washer Mfg. Lot Number(s): 163305
Bolt Specification: A354 BC
Bolt Length(s): 80"
Nut Specification: A563-DH
Washer Specification: F436-1
Finish: HDG
Diameter/Size: 1-1/2"
Bolt Mfg. Lot Number: 30637
Rocap Test Requirement(s): NA
Lubricant Requirements(s):
Test Results
