Sample Record

DIME Sample ID 2018-04-25-1

Project Information

Project IdentifiersProject ID: 213087
Permit Numbers: 0916NCS0245 0917NDP0279 0917NRW0191
DIST-CO-RTE-PM09-KER-14-16.3/17.1
Award Date12/29/2016
Closeout Date06/23/2021
Work DescriptionConstruct sidewalk, curb and gutter, as shown on the plans titled "Plans for Construction of Pedestrian Path Improvements on State Route 14 in Mojave, CA, Contract No. 16007" signed and stamped by Registered Civil Engineer Bryon A. Smith, RCE No. 61252.Notwithstanding General Provision #4,
Location DescriptionMojave, Mojave
QA Service Level1 (Verified on 02/01/2018)

Owner Lab

  • CT HQ - QASI Bay Area Field Office

Sample Information

Sample Taken Date04/25/2018 Sample Unique Key1
Date that the sample was received by the laboratory/organization performing the testing04/26/2018 Sample typeVerification
A brief description of the sample1 x 3-4 anchor bolt assembly The quantity of what the sample constitutes1
From where was the sample collectedFabricator First name of sampler or witnessed byDavid
Last name of sampler or witnessed byFlygare Title of samplerCA METS QA Inspector
Telephone number of sampler801-669-2984 Laboratory sample identificationUnknown
Linked DIME Sample IDUnknown The fabricator/manufacturer/facility nameEDSCO Fasteners
Transportation Laboratory (TL) NumberC719150 Inspector Lot Number from the Transportation Laboratory (TL) FormB76-078-18
Structure unique identifierNot set Structure nameNot set
Bid ItemNot set

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)none
Heat Number(s)M42681, DL17101378, 175125, DL12102282 Nut Mfg. Lot Number(s)Nucor 3257198, 393694A
Washer Mfg. Lot Number(s)Technical 1017-672 Bolt SpecificationF1554 Gr.105
Bolt Length(s)1" x 3'-4" Nut SpecificationA194 Gr.2H
Washer SpecificationF436 FinishHDG/plain
Diameter/Size1" x 3'-4" Bolt Mfg. Lot NumberKreher 78641
Rocap Test Requirement(s)none Lubricant Requirements(s)
Washer Inner Diameter(s) Bolt Mill SupplierNot set
Nut Mill SupplierNot set Washer Mill SupplierNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedDate AddedVerified?Release DateTest CommentsPrivacy LevelActions
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