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Sample Record for 2022-12-13-13

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Project Information

Project ID: 210037 DEA: 043G4424 EFIS: 0412000042 QA Service Level: 1
DIST-CO-RTE-PM: 04-SF-80-R5.6/7.6
Work Description: WEST SPAN DAMPER BRACKET A325 BOLT TESTING
Location Description: SFOBB WEST SPAN
Contractor Name: CALIFORNIA ENGINEERING CONTRACTORS, INC.
Contractor Address: 20 Happy Valley Road, Pleasanton, CA 94566
Resident Engineer: Tom Larwin Structure Rep.: Sergio Gomez

Sample Information

DIME Sample ID: 2022-12-13-13
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: Department Acceptance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 12/13/2022
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 300
A brief description of the sample: F3125 Grade F1852 1" x 2-3/4" Fastener
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: St Louis Screw and Bolt

Material Information

Rocap Number(s):
Heat Number(s): 10784400
Nut Mfg. Lot Number(s): 37335-10784400
Washer Mfg. Lot Number(s): 37335-10784400
Bolt Specification: F1852/A325 TC Domestic
Bolt Length(s): 2-3/4"
Nut Specification: F1852/A325 TC Domestic
Washer Specification: F1852/A325 TC Domestic
Finish:
Diameter/Size: 1"
Bolt Mfg. Lot Number: 37335-10784400
Rocap Test Requirement(s):
Lubricant Requirements(s):

Test Results