Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Laboratory

DIME Sample ID 2022-03-21-5

Project Information

Project IdentifiersProject ID: 214099
DEA: 024F5904
EFIS: 0213000010
DIST-CO-RTE-PM02-TEH-5-R25.4
Award Date07/08/2020
Closeout DateNot set
Work DescriptionBRIDGE SEISMIC RETROFIT AND SCOUR REPAIR.
Location DescriptionTEHAMA COUNTY IN RED BLUFF AT SACRAMENTO RIVER BRIDGE
QA Service Level1 (Verified on 05/07/2019)

Sample Information

Sample Taken Date03/21/2022 Sample Unique Key5
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 sample7/8" x 6 3/4" A449 HDG all thread rod with nuts and washers
The quantity of what the sample constitutes21 fastener assemblies From where was the sample collectedFabricator
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 ID2022-3-21-4
The fabricator/manufacturer/facility nameC&K Johnson Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormB9-037-22 Structure unique identifier08-0095 R/L
Structure nameSacramento River Bridge- I5

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)
Heat Number(s)10707140 bar nut- 35213 washer 0721-890 Nut Mfg. Lot Number(s)35213
Washer Mfg. Lot Number(s)0721-890 Bolt SpecificationA449
Bolt Length(s)6 3/4" Nut SpecificationA563 dh
Washer SpecificationF436 FinishHDGalv
Diameter/Size7/8" Bolt Mfg. Lot Number10707140
Rocap Test Requirement(s) Lubricant Requirements(s)yes

Submitted Tests

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