Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2017-07-18-8

Project Information

Project IdentifiersProject ID: 211948
DEA: 073W2204
EFIS: 0716000011
DIST-CO-RTE-PM07-LA-210-R0.0/R15.8
Award Date02/15/2017
Closeout Date08/28/2019
Work DescriptionREPLACE BRIDGE APPROACH SLABS AND REHABILITATE DECKS.
Location DescriptionLOS ANGELES COUNTY IN LOS ANGELES AND GLENDALE FROM NORTH CONNECTOR OVERCROSSING TO HONOLULU AVENUE UNDERCROSSING
QA Service Level1 (Verified on 04/20/2017)

Sample Information

Sample Taken Date07/18/2017 Sample Unique Key8
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 testingNot set
Sample typeQuality Assurance A brief description of the sampleThreaded Bar
The quantity of what the sample constitutes1 From where was the sample collectedFabricator
First name of sampler or witnessed byGeorge Last name of sampler or witnessed byLujan
Title of samplerQAI Telephone number of sampler951 640-5331
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameUlmer Industries Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL36-009-17 Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)
Heat Number(s)405414 Nut Mfg. Lot Number(s)
Washer Mfg. Lot Number(s) Bolt SpecificationASTM 307
Bolt Length(s)3'-8" Nut SpecificationN/A
Washer SpecificationN/A FinishHDG
Diameter/Size3/4" Bolt Mfg. Lot Number
Rocap Test Requirement(s) Lubricant Requirements(s)

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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