*Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Sample Record for 2020-03-06-9
Project ID: 77777 DEA: STOCK EFIS: STOCK QA Service Level:
Work Description: Special project for Chem Lab stock material. Object Code: 1025. J2 DEA: 912680.
Contractor Name: Contractor Address:
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2020-03-06-9
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7263
Type of Sample: Stock
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 03/06/2020
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 203
A brief description of the sample: 3/4" x 30" Anchor Bolt
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Heat Number(s): 3076376
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s):
Bolt Specification: tbd
Bolt Length(s): 30"
Nut Specification: tbd
Washer Specification: tbd
Diameter/Size: 3/4" x 30"
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):