Sample Record

DIME Sample ID 2023-09-12-11

Project Information

Project IdentifiersProject ID: 215479
DEA: 080R4204
EFIS: 0812000076
DIST-CO-RTE-PM08-SBD-SR 210 AND I-15 IC-Null
Award Date04/02/2021
Closeout Date12/10/2024
Work DescriptionFONTANA MAINTENANCE STATION
Location Description14032 Victoria Street, Fontana, CA 92336
QA Service Level1 (Verified on 02/11/2021)

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

Sample Information

Sample Taken Date09/12/2023 Sample Unique Key11
Date that the sample was received by the laboratory/organization performing the testing09/15/2023 Sample typeQuality Assurance
A brief description of the sample7/8 x 15 5/8" Anchor Bolts A36 The quantity of what the sample constitutes80
From where was the sample collectedFabricator First name of sampler or witnessed byHuidon
Last name of sampler or witnessed byJoo Title of samplerQuality Assurance Inspector
Telephone number of sampler562-447-5379 Laboratory sample identification
Linked DIME Sample ID The fabricator/manufacturer/facility nameMaya Steel Fabrications, Inc
Transportation Laboratory (TL) Number Inspector Lot Number from the Transportation Laboratory (TL) FormL163-067-23
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)N/A
Heat Number(s)223747, 190934 Nut Mfg. Lot Number(s)33301-190934
Washer Mfg. Lot Number(s)S1603001 Bolt SpecificationASTM F1554 Grade 36
Bolt Length(s)15 5/8" Nut SpecificationASTM A563, Grade DH
Washer SpecificationASTM F436 FinishBlack
Diameter/Size7/8" Bolt Mfg. Lot NumberALTON STEEL INC 223747
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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