Sample Record
Owner Lab
- CT HQ - Sacramento Structural Materials Testing Laboratory
DIME Sample ID 2019-01-28-13
Sample is locked from editing. info
Project Information
| Project Identifiers | Project ID: 212185 DEA: 024G5204 EFIS: 0214000022 |
|---|---|
| DIST-CO-RTE-PM | 02-SHA-5-R28.0 - R29.2 |
| Award Date | 05/21/2018 |
| Closeout Date | 09/02/2020 |
| Work Description | PIT RIVER BRIDGE DECK & CATWALK REHABILITATION |
| Location Description | SHASTA COUNTY ABOUT 6 MILES NORTH OF SHASTA LAKE FROM 0.2 MILE SOUTH TO 0.9 MILE NORTH OF PIT RIVER BRIDGE OVERHEAD |
| QA Service Level | 1 (Verified on 06/05/2017) |
Sample Information
| Sample Taken Date | 01/28/2019 | Sample Unique Key | 13 |
|---|---|---|---|
| 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 | 02/14/2019 |
| Sample type | Quality Assurance | A brief description of the sample | A325 Bolt Assembly |
| The quantity of what the sample constitutes | 5 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Jordan | Last name of sampler or witnessed by | Webb |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Midwest Structural Products | Transportation Laboratory (TL) Number | C733280 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | NA | 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) | 407093A | |
| Washer Mfg. Lot Number(s) | 310706 | Bolt Specification | A325 |
| Bolt Length(s) | 2.25 | Nut Specification | A563 |
| Washer Specification | F436 | Finish | MG |
| Diameter/Size | .625 | Bolt Mfg. Lot Number | 413227A |
| Rocap Test Requirement(s) | Lubricant Requirements(s) |
Submitted Tests
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