Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2024-04-09-1
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Project Information
| Project Identifiers | Project ID: 994737 DEA: 081M1704 EFIS: 0821000086 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-15,71,91,215-Var |
| Award Date | 06/30/2023 |
| Closeout Date | 08/30/2024 |
| Work Description | STRUCTURAL CONCRETE AND POLYESTER CONCRETE OVERLAY. |
| Location Description | RIVERSIDE COUNTY AT VARIOUS LOCATIONS |
| QA Service Level | 1 (Verified on 08/15/2023) |
Sample Information
| Sample Taken Date | 04/09/2024 | Sample Unique Key | 1 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | Yes | Date that the sample was received by the laboratory/organization performing the testing | 04/16/2024 |
| Sample type | Quality Assurance | A brief description of the sample | 2 pcs 3/4"x3" A325 Bolt Assemblies |
| The quantity of what the sample constitutes | 15 Bolt Assemblies | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Preston | Last name of sampler or witnessed by | Brockett |
| Title of sampler | Quality Assurance Inspector | Telephone number of sampler | 5627836180 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | St. Louis Screw & Bolt | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L175-025-24 | Structure unique identifier | |
| Structure name | Bid Item | Not set |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | V072059 |
|---|---|---|---|
| Heat Number(s) | 10858270 Bolt 5805575204 Nut 32320750 Washer | Nut Mfg. Lot Number(s) | 38614-5805575204 |
| Washer Mfg. Lot Number(s) | 0623-771 | Bolt Specification | ASTM A325-1 |
| Bolt Length(s) | 3" | Nut Specification | ASTM A563-DH |
| Washer Specification | ASTM F436-1 | Finish | Plain |
| Diameter/Size | 3/4" | Bolt Mfg. Lot Number | 050513 |
| Rocap Test Requirement(s) | Lubricant Requirements(s) | ||
| Washer Inner Diameter(s) |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| 08-1M1704_6034_L175_04-09-2024_293_DOCS | 04/17/2024 | Info |
Test File Attachments
DIME Test ID: 2024-04-09-1-1 ASTM F606-21 (Verified)
DIME Test ID: 2024-04-09-1-2 ASTM F606-21 (Verified)
DIME Test ID: 2024-04-09-1-3 ASME B1.2-83r17 (Verified)
DIME Test ID: 2024-04-09-1-6 ASME B1.2-83r17 (Verified)
DIME Test ID: 2024-04-09-1-7 ASTM E18-20 (Verified)