Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2021-03-09-16
Project Information
| Project Identifiers | Project ID: 214601 DEA: 041J5694 EFIS: 0419000313 |
|---|---|
| DIST-CO-RTE-PM | 04-SM-101-0.0/21.8 |
| Award Date | 12/03/2019 |
| Closeout Date | 09/28/2022 |
| Work Description | San Mateo US 101 Express Lanes North |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 04/08/2022) |
Sample Information
| Sample Taken Date | 03/09/2021 | Sample Unique Key | 16 |
|---|---|---|---|
| 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 | Not set |
| Sample type | Quality Assurance | A brief description of the sample | Bolt Assy |
| The quantity of what the sample constitutes | 1 lot of 19 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | David | Last name of sampler or witnessed by | Gray |
| Title of sampler | QAI | Telephone number of sampler | 5593134832 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Structural and Steel Products | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | S32-002-21 | Structure unique identifier | |
| Structure name | OHSS | Bid Item | Not set |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | 441480AR |
|---|---|---|---|
| Heat Number(s) | 100203581 | Nut Mfg. Lot Number(s) | 42574A |
| Washer Mfg. Lot Number(s) | D6577 | Bolt Specification | ASTM F3125, A325 |
| Bolt Length(s) | 3-1/2"" | Nut Specification | ASTM A563 |
| Washer Specification | ASTM A436 | Finish | ASTM B569 |
| Diameter/Size | 7/8" | Bolt Mfg. Lot Number | 441490A |
| Rocap Test Requirement(s) | Yes | Lubricant Requirements(s) | Yes |
| Washer Inner Diameter(s) |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Date Added | Verified? | Release Date | Test Comments | Privacy Level | Actions |
|---|---|---|---|---|---|---|---|---|---|
| No results found. | |||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
