Sample Record
Owner Lab
- CT HQ - QASI Sacramento Field Office
DIME Sample ID 2025-12-15-5
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 1001375 DEA: 040A53T4 EFIS: 0421000155 COOP: 040A53TCM |
|---|---|
| DIST-CO-RTE-PM | 04-SOL-80-L1.8/L3.2 |
| Award Date | 06/20/2025 |
| Closeout Date | Not set |
| Work Description | Construct I-80 WB Truck Scales |
| Location Description | CONSTRUCTION ON STATE HIGHWAY IN SOLANO COUNTY IN AND NEAR FAIRFIELD ON ROUTE 12 FROM THE 80/12 EAST JUNCTION TO 0.9 MILE EAST OF CHADBOURNE ROAD UNDERCROSSING AND ON ROUTE 80 FROM 0.5 MILE WEST OF DAN WILSON CREEK BRIDGE TO WEST TEXAS STREET UNDERCROSSI |
| QA Service Level | 1 (Verified on 07/10/2025) |
Sample Information
| Sample Taken Date | 12/15/2025 | Sample Unique Key | 5 |
|---|---|---|---|
| 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 | 12/22/2025 |
| Sample type | Quality Assurance | A brief description of the sample | 1-1/2" A563 DH Nut |
| The quantity of what the sample constitutes | 132 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Jamie | Last name of sampler or witnessed by | Doe |
| Title of sampler | QA Inspector | Telephone number of sampler | (916) 838-4405 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Metal Works, Oroville, VA | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | S50-059-25 | Structure unique identifier | |
| Structure name | Bid Item | Not set |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | |
|---|---|---|---|
| Heat Number(s) | Nut 3081090 | Nut Mfg. Lot Number(s) | W113484 |
| Washer Mfg. Lot Number(s) | Bolt Specification | N/A | |
| Bolt Length(s) | Nut Specification | 1 1/2-6" dom. galv. A563-DH heavy hex jam nut | |
| Washer Specification | N/a | Finish | HDG |
| Diameter/Size | 1-1/2" | Bolt Mfg. Lot Number | |
| Rocap Test Requirement(s) | Lubricant Requirements(s) | ||
| Washer Inner Diameter(s) |
Submitted Tests
Test File Attachments
DIME Test ID: 2025-12-15-5-1 ASTM B499-09r21 (Verified)
DIME Test ID: 2025-12-15-5-2 ASTM B499-09r21 (Verified)
DIME Test ID: 2025-12-15-5-3 ASTM E18-20 (Verified)
DIME Test ID: 2025-12-15-5-4 ASTM E18-20 (Verified)