Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2026-06-25-23

Project Information

Project IdentifiersProject ID: 994415
DEA: 120R3114
EFIS: 1220000021
DIST-CO-RTE-PM12-LA,ORA-91-R20.6/R20.7,R0.0/4.8
Award Date03/03/2025
Closeout DateNot set
Work DescriptionPLACE JPCP (RSC) AND RHMA, AND MODIFY ELECTRICAL SYSTEMS.
Location DescriptionLOS ANGELES AND ORANGE COUNTIES FROM 0.1 MILE WEST OF THE LOS ANGLES COUNTY LINE IN CERRITOS TO 0.1 MILE EAST OF ACACIA STREET UNDERCROSSING IN ANAHEIM
QA Service Level1 (Verified on 07/07/2023)

Sample Information

Sample Taken Date06/25/2026 Sample Unique Key23
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing06/25/2026
Sample typeQuality Assurance A brief description of the sample1.25" Washers (Replacement)
The quantity of what the sample constitutes12 From where was the sample collectedSource
First name of sampler or witnessed byJayce Last name of sampler or witnessed byGroves
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHalo Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name Bid ItemNot set

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)No
Heat Number(s)148668 Nut Mfg. Lot Number(s)N/A
Washer Mfg. Lot Number(s)148668 Bolt SpecificationN/A
Bolt Length(s)N/A Nut SpecificationN/A
Washer SpecificationN/A FinishGalvanized
Diameter/Size1.25" Washers Bolt Mfg. Lot NumberN/A
Rocap Test Requirement(s)No Lubricant Requirements(s)No
Washer Inner Diameter(s)one and seven sixteenths

Submitted Tests

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