Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2019-11-13-19

Project Information

Project IdentifiersProject ID: 214399
DEA: 044Q3404
EFIS: 0419000383
DIST-CO-RTE-PM04-MRN-580-1.3, 1.30
Award Date05/23/2019
Closeout Date03/16/2021
Work DescriptionNear San Quentin, in the Richmond-San Rafael Bridge, heat straightening truss chords
Location DescriptionNear San Quentin, in the Richmond-San Rafael Bridge
QA Service Level1 (Verified on 09/06/2019)

Sample Information

Sample Taken Date11/13/2019 Sample Unique Key19
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 testing11/19/2019
Sample typeQuality Assurance A brief description of the sample3/4" F436 Hot Dip galv bevel washers
The quantity of what the sample constitutes24 From where was the sample collectedDistributor
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 nameBay Bolt Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormB9-113-19 Structure unique identifier
Structure nameunknown

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)
Heat Number(s)A172357 Nut Mfg. Lot Number(s)
Washer Mfg. Lot Number(s)D4748 Bolt Specificationnone
Bolt Length(s)Unknown Nut Specificationnone
Washer SpecificationF436 HDG Bevel washer FinishHot Dip Galv.
Diameter/Size3/4" Bolt Mfg. Lot Number
Rocap Test Requirement(s) Lubricant Requirements(s)

Submitted Tests

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