Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2025-10-07-1
Project Information
| Project Identifiers | Project ID: 215365 DEA: 120Q9704 EFIS: 1218000010 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-405-0/11.4 |
| Award Date | 07/27/2023 |
| Closeout Date | Not set |
| Work Description | I-405 improvement project from I-5 to Harbor Boulevard including extend pavement life, improve safety, enhance traffic operation, and incorporate Intelligent Transportation Systems (ITS). |
| Location Description | Orange County I-405 PM 0 - 11.4 |
| QA Service Level | 1 (Verified on 07/01/2021) |
Sample Information
| Sample Taken Date | 10/07/2025 | Sample Unique Key | 1 |
|---|---|---|---|
| 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 testing | 10/15/2025 |
| Sample type | Quality Assurance | A brief description of the sample | Anchor Bolt Assembly |
| The quantity of what the sample constitutes | 26 | From where was the sample collected | Supplier |
| First name of sampler or witnessed by | Sherri | Last name of sampler or witnessed by | Brannon |
| Title of sampler | Quality Assurance Inspector | Telephone number of sampler | 9168266371 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Madden Bolt | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | B22-128-25 | Structure unique identifier | |
| Structure name | Bid Item | Not set |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | |
|---|---|---|---|
| Heat Number(s) | 58066514, 20987830 HDG Nut, 20937220 Plain Nut, 32507650 | Nut Mfg. Lot Number(s) | BZDT HDG, BVSD PLAIN |
| Washer Mfg. Lot Number(s) | 0325-596 HDG | Bolt Specification | F1554 Gr55 |
| Bolt Length(s) | 52" | Nut Specification | A563 |
| Washer Specification | F436 | Finish | HDG |
| Diameter/Size | 2-1/4 | Bolt Mfg. Lot Number | |
| Rocap Test Requirement(s) | Lubricant Requirements(s) | Hex nuts HDG wax and dye | |
| Washer Inner Diameter(s) |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| Dime 2025-10-07-1_QAB22-128-25_10-07-25_v5192 | 10/09/2025 | Info |
Test File Attachments
DIME Test ID: 2025-10-07-1-1 ASME B1.2-83r17 (Verified)
DIME Test ID: 2025-10-07-1-2 ASTM B499-09r21 (Verified)
DIME Test ID: 2025-10-07-1-3 ASTM B499-09r21 (Verified)
DIME Test ID: 2025-10-07-1-4 ASTM B499-09r21 (Verified)
DIME Test ID: 2025-10-07-1-5 ASTM B499-09r21 (Verified)
DIME Test ID: 2025-10-07-1-6 ASTM B499-09r21 (Verified)
DIME Test ID: 2025-10-07-1-7 ASTM E18-20 (Verified)
DIME Test ID: 2025-10-07-1-8 ASTM E18-20 (Verified)
DIME Test ID: 2025-10-07-1-9 ASTM E18-20 (Verified)
DIME Test ID: 2025-10-07-1-10 ASTM E18-20 (Verified)
DIME Test ID: 2025-10-07-1-11 ASTM E18-20 (Verified)
DIME Test ID: 2025-10-07-1-12 ASTM E18-20 (Verified)
DIME Test ID: 2025-10-07-1-13 ASTM F606-21 (Verified)
