Sample Record

DIME Sample ID 2023-04-18-16

Project Information

Project IdentifiersProject ID: 213903
DEA: 043G4544
EFIS: 0412000054
DIST-CO-RTE-PM04-ALA,SM-92-R14.4/R18.8,R0.0/R.2.4
Award Date12/31/2019
Closeout Date04/04/2025
Work DescriptionRepair Spalled Concrete Columns and Spandrel Beams
Location DescriptionSan Mateo-Hayward Bridge
QA Service Level1 (Verified on 01/22/2019)

Owner Lab

  • CT HQ - QASI Sacramento Field Office

Sample Information

Sample Taken Date04/18/2023 Sample Unique Key16
Date that the sample was received by the laboratory/organization performing the testing04/20/2023 Sample typeQuality Assurance
A brief description of the sample1035MR Cap The quantity of what the sample constitutes31
From where was the sample collectedFabricator First name of sampler or witnessed bySherri
Last name of sampler or witnessed byBrannon Title of samplerCT METS QA INSPECTOR
Telephone number of sampler9168266371 Laboratory sample identification
Linked DIME Sample ID The fabricator/manufacturer/facility nameXKT Engineering
Transportation Laboratory (TL) Number Inspector Lot Number from the Transportation Laboratory (TL) FormB22-155-23
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)
Heat Number(s)1000217207 Nut Mfg. Lot Number(s)
Washer Mfg. Lot Number(s) Bolt Specification1035
Bolt Length(s)1 1/2 Nut SpecificationNA
Washer SpecificationNA Finish
Diameter/Size3/8 Bolt Mfg. Lot Number476026B
Rocap Test Requirement(s) 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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