Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Laboratory

DIME Sample ID 2022-02-04-2

Project Information

Project IdentifiersProject ID: 215255
DEA: 040A7714
EFIS: 0420000287
DIST-CO-RTE-PM04-ALA-80-6.4-6.6
Award Date05/03/2021
Closeout DateNot set
Work DescriptionCONSTRUCT PEDESTRIAN OVERCROSSING BRIDGE AND RETAINING WALLS. GILMAN INTERCHANGE IMPROVEMENTS
Location DescriptionALAMEDA COUNTY IN BERKELEY FROM 0.6 MILE NORTH OF UNIVERSITY AVENUE OVERCROSSING TO 0.1 MILE SOUTH OF GILMAN STREET UNDERCROSSING
QA Service Level1 (Verified on 12/07/2020)

Sample Information

Sample Taken Date02/04/2022 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 typeQuality Control A brief description of the sample1-1/2x80" A354 GR BC HDG
The quantity of what the sample constitutes64 From where was the sample collectedManufacturer
First name of sampler or witnessed byCharles C Last name of sampler or witnessed byFranco
Title of samplerQA Inspector Telephone number of sampler858-583-9270
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility namePortland Bolt - Oregon Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameGilman Street Bridge

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)
Heat Number(s)20743200, 201522, 41635670 Nut Mfg. Lot Number(s)DECR
Washer Mfg. Lot Number(s)163305 Bolt SpecificationA354 BC
Bolt Length(s)80" Nut SpecificationA563-DH
Washer SpecificationF436-1 FinishHDG
Diameter/Size1-1/2" Bolt Mfg. Lot Number30637
Rocap Test Requirement(s)NA Lubricant Requirements(s)

Submitted Tests

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