Sample Record

Owner Lab

  • CT QASI - Bay Area Field Laboratory

DIME Sample ID 2019-05-10-8

Project Information

Project IdentifiersProject ID: 210037
DEA: 043G4424
EFIS: 0412000042
DIST-CO-RTE-PM04-SF-80-R5.6/7.6
Award Date03/22/2018
Closeout DateNot set
Work DescriptionWEST SPAN DAMPER BRACKET A325 BOLT TESTING
Location DescriptionSFOBB WEST SPAN
QA Service Level1 (Verified on 11/04/2014)

Sample Information

Sample Taken Date05/10/2019 Sample Unique Key8
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing05/14/2019
Sample typeQuality Assurance A brief description of the sample1" dia A490 bolt assemblies
The quantity of what the sample constitutes354 From where was the sample collectedJob Site
First name of sampler or witnessed byGreg Last name of sampler or witnessed byThompson
Title of samplerAssociate Steel Inspector Telephone number of sampler510-376-7155
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCalifornia Engineering Contractor Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormB9-041-19 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)TT0113074
Heat Number(s)10426680 Nut Mfg. Lot Number(s)29402-6214745403
Washer Mfg. Lot Number(s)D6838 Bolt SpecificationA490
Bolt Length(s)9" Nut SpecificationA563-DH
Washer SpecificationF436 Finishplain
Diameter/Size1" Bolt Mfg. Lot Number040810
Rocap Test Requirement(s) Lubricant Requirements(s)

Submitted Tests

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