Sample Record

Owner Lab

  • Caltrans Vallejo Field Laboratory

DIME Sample ID 2020-08-03-3

Project Information

Project IdentifiersProject ID: 212501
DEA: 022E4804
EFIS: 0200000586
DIST-CO-RTE-PM02-SIS-96,263-103.1/103.6,56.8/57.2
Award Date12/14/2018
Closeout DateNot set
Work DescriptionBRIDGE REPLACEMENT
Location DescriptionSISKIYOU COUNTY ABOUT 8 MILES NORTH OF YREKA ON ROUTE 96 FROM 0.5 MILE WEST TO 0.2 MILE EAST OF ROUTE 263 AND ON ROUTE 263 FROM 0.3 MILE NORTH OF SHASTA RIVER BRIDGE #02-0014 TO ROUTE 96
QA Service Level1 (Verified on 06/06/2017)

Sample Information

Sample Taken Date08/03/2020 Sample Unique Key3
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 typeQuality Assurance A brief description of the sample1/2" x 3-1/2" A325 bolts, 1/2" A563-DH nuts and 1/2" F436 washers
The quantity of what the sample constitutes87/87/174 From where was the sample collectedFabricator
First name of sampler or witnessed byCraig Last name of sampler or witnessed byHager
Title of samplerQA Inspector Telephone number of sampler925-899-1184
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameUIS Lindon UT Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormB29-033-20 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)TT0131087
Heat Number(s)bolts - 20495460, nuts - 20650010, washers - 190394 Nut Mfg. Lot Number(s)L511Q1
Washer Mfg. Lot Number(s)957-190394 Bolt SpecificationA325
Bolt Length(s)3-1/2" Nut SpecificationA563-DH
Washer SpecificationF436 FinishHDG - all
Diameter/Size1/2" Bolt Mfg. Lot NumberG9825
Rocap Test Requirement(s)Yes Lubricant Requirements(s)none

Submitted Tests

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