Sample Record

Owner Lab

  • CT HQ - QASI Sacramento Field Office

DIME Sample ID 2019-08-26-1

Project Information

Project IdentifiersProject ID: 213570
DEA: 033F5504
EFIS: 0313000137
DIST-CO-RTE-PM03-YOL,SAC-275-13.0,0.0
Award Date12/07/2018
Closeout Date06/21/2022
Work DescriptionREPLACE TIMBER FENDER SYSTEM SURROUNDING PIERS 6 AND 7
Location DescriptionYOLO AND SACRAMENTO COUNTIES IN WEST SACRAMENTO AND SACRAMENTO AT SACRAMENTO RIVER BRIDGE.
QA Service Level1 (Verified on 01/08/2019)

Sample Information

Sample Taken Date08/26/2019 Sample Unique Key1
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 testing08/26/2019
Sample typeAcceptance A brief description of the sampleA325 HDG BOLT ASSEMBLY
The quantity of what the sample constitutes4,000 From where was the sample collectedJob Site
First name of sampler or witnessed byMahlon Last name of sampler or witnessed byLindenmuth
Title of sampler Telephone number of sampler646-740-3704
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameGolden State Bridge Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormS46-791-19 Structure unique identifier
Structure nameTower Bridge

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)Not Required
Heat Number(s)100889992, 100892134, 752109 Nut Mfg. Lot Number(s)2734775068952
Washer Mfg. Lot Number(s)303371 Bolt SpecificationA325
Bolt Length(s)3.75" Nut SpecificationASTM A563
Washer SpecificationASME B18.21.1 FinishHDG
Diameter/Size5/8" Bolt Mfg. Lot Number404635A, 414509A, 752109
Rocap Test Requirement(s)Not Required Lubricant Requirements(s)Lubricated Blue Dye

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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