Sample Record for 2023-04-10-53
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214590 DEA: 043G4744 EFIS: 0412000074
QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN,MRN-580-6.9/7.8,0.0/2.5
Work Description: CLEAN AND PAINT STRUCTURAL STEEL BRIDGE.
Location Description: CONTRA COSTA AND MARIN COUNTIES IN RICHMOND AND SAN RAFAEL FROM 0.8 MILE WEST OF TOLL PLAZA TO 0.1 MILE EAST OF MAIN STREET
Contractor Name: Allied Painting, INC.
Contractor Address: 4 Larwin Road, Cherry Hill, NJ08034
Resident Engineer: Behzad Halali Structure Rep.: William Sommer
Sample Information
DIME Sample ID: 2023-04-10-53
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 Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 04/10/2023
Date that the sample was received by the laboratory/organization performing the testing: 04/10/2023
The quantity of what the sample constitutes: 26
A brief description of the sample: ASTM A325 7/8x2-3/4
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Bay Bolt, Inc.
Material Information
Rocap Number(s): 5019-01
Heat Number(s): 100897401
Nut Mfg. Lot Number(s): 472199B
Washer Mfg. Lot Number(s): 167117
Bolt Specification: ASTM A325
Bolt Length(s): 2-3/4
Nut Specification: ASTM A563
Washer Specification: ASTM436
Finish: Galv
Diameter/Size: 7/8
Bolt Mfg. Lot Number: 424788A
Rocap Test Requirement(s):
Lubricant Requirements(s):
Test Results
