Sample Record

Owner Lab

  • CT - Unassigned/General Field Laboratory

DIME Sample ID 2018-12-28-2

Project Information

Project IdentifiersProject ID: 208945
DEA: 07288604
EFIS: 0700021080
COOP: 074663
DIST-CO-RTE-PM07-LA-710-6.0-9.4
Award Date09/02/2011
Closeout DateNot set
Work DescriptionGerald Desmond Bridge Replacement - A Design Build project. IQA samples will be selected by Port/Caltrans representatives and sent to Translab for testing.
Location DescriptionPort of Long Beach (District 7)
QA Service Level1 (Verified on 06/03/2013)

Sample Information

Sample Taken Date12/28/2018 Sample Unique Key2
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testingNot set
Sample typeIndependent Assurance A brief description of the sampleF3125 GR A325 Fastener Assembly
The quantity of what the sample constitutes135 From where was the sample collectedJob Site
First name of sampler or witnessed byWilliam Last name of sampler or witnessed byClifford
Title of samplerINDEPENDENT QA Telephone number of sampler5103253065
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameUnytite Inc Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)29042-10558410-CALTRANS
Heat Number(s) Nut Mfg. Lot Number(s)29076-6214709002
Washer Mfg. Lot Number(s)D6240 Bolt SpecificationF3125
Bolt Length(s) Nut SpecificationA563 DH
Washer SpecificationF436 Finish
Diameter/Size Bolt Mfg. Lot Number29042-10554810
Rocap Test Requirement(s) Lubricant Requirements(s)

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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