Sample Record

Owner Lab

  • CT QASI - Sacramento Field Laboratory

DIME Sample ID 2019-02-05-1

Project Information

Project IdentifiersProject ID: 212687
DEA: 06442544
EFIS: 0612000175
DIST-CO-RTE-PM06-KER-46,5-31.5-33.2
Award Date01/11/2018
Closeout Date11/19/2021
Work DescriptionCONVERT 2-LANE TO 4-LANE CONVENTIONAL HIGHWAY.
Location DescriptionKERN COUNTY NEAR LOST HILLS FROM 1.0 MILE EAST OF LOST HILLS ROAD TO 0.7 MILE EAST OF ROUTE 46/5 SEPARATION
QA Service Level1 (Verified on 03/12/2018)

Sample Information

Sample Taken Date02/05/2019 Sample Unique Key1
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 testing02/08/2019
Sample typeQuality Assurance A brief description of the sampleF1554 Grade 55 HDG Anchor Bolts
The quantity of what the sample constitutes4 From where was the sample collectedManufacturer
First name of sampler or witnessed byRob Last name of sampler or witnessed byRAMOS
Title of samplerQA Telephone number of sampler916-996-2658
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility namePlatte Anchor Bolt Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormS08-01819 Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)N/A
Heat Number(s)3051299 Nut Mfg. Lot Number(s)21979-6213174804
Washer Mfg. Lot Number(s)292683 Bolt Specification1554 Gr.55
Bolt Length(s)24", 26 1/4" Nut SpecificationA563
Washer SpecificationF436 FinishHDG
Diameter/Size1-1/8 Bolt Mfg. Lot Number3051299
Rocap Test Requirement(s) Lubricant Requirements(s)

Submitted Tests

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