Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2022-11-10-17
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Project Information
| Project Identifiers | Project ID: 994220 DEA: 024J3204 EFIS: 0223000012 |
|---|---|
| DIST-CO-RTE-PM | 02-SIS/SIS-96-0/105.82 |
| Award Date | 08/01/2022 |
| Closeout Date | 08/10/2023 |
| Work Description | Remove and dispose of hazard trees, replace burnt wood posts, replace damaged culverts, install system hardening components (drainage, slopes, etc.) repair/replace damaged pavement, repair bridge damage and other miscellaneous associated items of work. |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 09/14/2022) |
Sample Information
| Sample Taken Date | 11/10/2022 | Sample Unique Key | 17 |
|---|---|---|---|
| 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 | 7/8 x2 A325 HDG fastener assemblies |
| The quantity of what the sample constitutes | 314 ea | From where was the sample collected | Distributor |
| First name of sampler or witnessed by | Greg | Last name of sampler or witnessed by | Thompson |
| Title of sampler | Associate Steel Inspector | Telephone number of sampler | 510-376-7155 |
| Laboratory sample identification | Linked DIME Sample ID | 2022-11-10-16 | |
| The fabricator/manufacturer/facility name | Bay Bolt | Transportation Laboratory (TL) Number | C926092 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | B9-177-22 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | 1706-01 |
|---|---|---|---|
| Heat Number(s) | Bolt 10695940 Nut 8000014475 washer 32028550 | Nut Mfg. Lot Number(s) | 472199B |
| Washer Mfg. Lot Number(s) | 167117 | Bolt Specification | A325 |
| Bolt Length(s) | 2" | Nut Specification | A563 |
| Washer Specification | F436 | Finish | HDG |
| Diameter/Size | 7/8 | Bolt Mfg. Lot Number | L737V1 |
| Rocap Test Requirement(s) | yes | Lubricant Requirements(s) | yes |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||