Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2017-09-19-2
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 211796 DEA: 073X8704 EFIS: 0713000241 |
|---|---|
| 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 | 2 |
|---|---|---|---|
| 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) | |
|---|---|---|---|
| Heat Number(s) | Nut Mfg. Lot Number(s) | ||
| Washer Mfg. Lot Number(s) | Bolt Specification | A325 | |
| Bolt Length(s) | Unknown | Nut Specification | A563 |
| Washer Specification | F436 | 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 |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||