Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2017-09-19-1
Project Information
Project Identifiers | Project ID: 211796 DEA: 073X8704 EFIS: 0713000241 |
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DIST-CO-RTE-PM | 07-LA-105,405-R2.5,20.5/R21.1 |
Award Date | 12/29/2016 |
Closeout Date | 04/08/2020 |
Work Description | SLOPE RECONSTRUCTION AND PAVEMENT REPAIR |
Location Description | LOS ANGELES COUNTY IN AND NEAR HAWTHORNE FROM EL SEGUNDO BOULEVARD UNDERCROSSING TO ROUTE 105/405 SEPARATION |
QA Service Level | 1 (Verified on 03/14/2017) |
Sample Information
Sample Taken Date | 09/19/2017 | Sample Unique Key | 1 |
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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 | 09/22/2017 |
Sample type | Quality Assurance | A brief description of the sample | A325 Fastener Assembly |
The quantity of what the sample constitutes | 50 | From where was the sample collected | Fabricator |
First name of sampler or witnessed by | Prakash | Last name of sampler or witnessed by | Patel |
Title of sampler | TET II | Telephone number of sampler | (562) 665-4686 |
Laboratory sample identification | Unknown | Linked DIME Sample ID | Unknown |
The fabricator/manufacturer/facility name | Structural and Steel Products | Transportation Laboratory (TL) Number | Unknown |
Inspector Lot Number from the Transportation Laboratory (TL) Form | L11-051-17 | Structure unique identifier | Not set |
Structure name | Not set |
Material Information
Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | |
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Heat Number(s) | Nut Mfg. Lot Number(s) | ||
Washer Mfg. Lot Number(s) | Bolt Specification | F1554 | |
Bolt Length(s) | Unknown | Nut Specification | DH |
Washer Specification | Harden | Finish | |
Diameter/Size | Unknown | Bolt Mfg. Lot Number | |
Rocap Test Requirement(s) | Lubricant Requirements(s) |
Submitted Tests
DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
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No results found. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |