Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2017-11-06-1
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 211889 DEA: 08368514 EFIS: 0813000077 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-15-81.1/87.5&177.3/181.1 |
| Award Date | 05/02/2017 |
| Closeout Date | 12/09/2019 |
| Work Description | CONSTRUCT AIF AND DEMOLISH EXISTING AIF IN YERMO |
| Location Description | SAN BERNARDINO COUNTY FROM 0.6 MILE NORTH OF YERMO ROAD OVERCROSSING TO 1.0 MILE SOUTH OF MINNEOLA ROAD OVERCROSSING AND FROM 1.2 MILE NORTH OF NIPTON ROAD OVERCROSSING TO 0.5 MILE SOUTH OF YATES WELL ROAD OVERCROSSING |
| QA Service Level | 1 (Verified on 04/07/2017) |
Sample Information
| Sample Taken Date | 11/06/2017 | 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 | 11/07/2017 |
| Sample type | Verification | A brief description of the sample | Anchor Bolt Assembly |
| The quantity of what the sample constitutes | 1 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | David | Last name of sampler or witnessed by | Flygare |
| Title of sampler | CA METS QA Inspector | Telephone number of sampler | 801-669-2984 |
| Laboratory sample identification | Unknown | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | EDSCO | Transportation Laboratory (TL) Number | C719147 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | B76-182-17 | Structure unique identifier | Not set |
| Structure name | Not set |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | n/a |
|---|---|---|---|
| Heat Number(s) | 3070316 | Nut Mfg. Lot Number(s) | Dyson lot DDTL, DDBM |
| Washer Mfg. Lot Number(s) | n/a | Bolt Specification | F1554 Gr.55 |
| Bolt Length(s) | 4'-5" | Nut Specification | A563-DH |
| Washer Specification | F436 | Finish | HDG/plain |
| Diameter/Size | 1 1/2" x 4'-5" | Bolt Mfg. Lot Number | n/a |
| Rocap Test Requirement(s) | none | Lubricant Requirements(s) | none |
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. | |||