Sample Record
Owner Lab
- CT HQ - QASI Sacramento Field Office
DIME Sample ID 2018-09-17-9
Project Information
Project Identifiers | Project ID: 212726 DEA: 030F3514 EFIS: 0316000080 |
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DIST-CO-RTE-PM | 03-SAC-51,99-VAR |
Award Date | 02/08/2018 |
Closeout Date | 12/08/2021 |
Work Description | ROADWAY EXCAVATION, HOT MIX ASPHALT AND MODIFY ELECTRICAL SYSTEM; SOLDIER PILES; CONCRETE RETAINING WALL |
Location Description | SACRAMENTO COUNTY FROM 0.5 MILE SOUTH OF COSUMNES RIVER BOULEVARD TO 0.2 MILE EAST OF ARDEN WAY UNDERCROSSING |
QA Service Level | 1 (Verified on 04/02/2018) |
Sample Information
Sample Taken Date | 09/17/2018 | Sample Unique Key | 9 |
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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 | 09/19/2018 |
Sample type | Quality Assurance | A brief description of the sample | F1554 Anchor Rods Nut Washers |
The quantity of what the sample constitutes | 17 | From where was the sample collected | Source |
First name of sampler or witnessed by | Joe | Last name of sampler or witnessed by | Adame |
Title of sampler | QA | Telephone number of sampler | 360-953-1155 |
Laboratory sample identification | Unknown | Linked DIME Sample ID | Unknown |
The fabricator/manufacturer/facility name | Portland Bolt | Transportation Laboratory (TL) Number | C874456 |
Inspector Lot Number from the Transportation Laboratory (TL) Form | S43-043-18 | 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) | PL16207513 | Nut Mfg. Lot Number(s) | 28769-622114705402 |
Washer Mfg. Lot Number(s) | 350118208020 | Bolt Specification | F1554 |
Bolt Length(s) | 10'' | Nut Specification | A563 |
Washer Specification | A36/A529 | Finish | HDG |
Diameter/Size | 3/4'' | Bolt Mfg. Lot Number | PL162075135 |
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. |